Anti-Ma and anti-Ta associated paraneoplastic neurological syndromes: 22 newly diagnosed patients and review of previous cases

Background: Paraneoplastic neurological syndromes (PNS) are
indirect remote effects of cancer on the nervous system, often
associated with the presence of specific serum antibodies. The most
recently described PNS defining reactivity is anti-Ma/anti-Ta. Here
we present 22 newly diagnosed patients with anti-Ma or anti-Ta
reactivity, refine the associated clinical picture and review all
published patients to date.Patients and methods: Patients were
identified by testing for PNMA1 and PNMA2 antibodies by western
blotting and indirect immunofluorescence. Clinical data were
obtained either by referral of the patient or from the referring
physicians.Results: Analysis of 22 new patients (14 anti-Ma, eight
anti-Ta) confirmed that anti-Ta are usually found in young men with
limbic encephalitis and testicular germ cell tumours who stabilise
neurologically with long term survival after tumour treatment.
Patients with anti-Ma were of either sex, middle-aged, presented
with a range of tumours and neurological symptoms and had a limited
response to treatment. Furthermore, we expanded the range of
associated clinical features: (1) the peripheral nervous system may
be involved; (2) an overlap with anti-Hu is possible; and (3)
testicular tumour manifestation can be extragonadal or detectable
only at orchiectomy.Conclusion: Refining and expanding the range of
anti-Ma/anti-Ta associated neurological presentations and tumours
clearly demonstrated that the distinction between anti-Ma and
anti-Ta associated PNS is of high clinical relevance.