Question

Buttaro lists oncology complications and paraneoplastic syndromes in Chapter 244. Pick one of these diagnoses and discuss the epidemiology, pathophysiology, clinical presentation/physical examination, diagnostics, differential diagnosis, and management. Have you had experience with this condition?

Answer 1

PARANEOPLASTIC SYNDROME:- It is a rare disorder that was triggered by an altered immune system response of neoplasm.it was defined as the clinical syndromes which are involving non metastatic systemic effects that accompany malignant disease.

EPIDEMIOLOGY:- the incidence rate is 10-15% to 2-20%of malignancies.There is no race prediction or sex prediction,people of all ages are affected by cancers and their related paraneoplastic syndromes .

PATHOPHYSIOLOGY:- paraneoplastic syndrome is a complex and intriguing.when a tumor arises -body produce antibodies -binds to the tumor cells and destroy them - some cases the antibodies cross react with normal tissues and destroy them- which ultimately re3sult in paraneoplastic syndrome.

PHYSCICAL EXAMINATION:- As with the history physical examination findings in patients with paraneoplastic syndromes are divided into categories bases on type of cancer

-MISCELLANEOUS /NON SPECIFIC :fever generally occurs in evening and continual remittent type.Dysgeusia,Anorexia even cachexia

-RHEUMATOLOGIC PARANEOPLASTIC SYNDROME:includes hypertrophic osteoarthropathy, polymyositis and dermatomyositis,scleroderma,systemic lupus erythematous

-RENAL PARANEOPLASTIC SYNDROMES: include edema resulting from hypoalbuminemia and protienuria (>3g/24h), hypercholesterolemia may be present

-GASTROINTESTINAL SYNDROME: similar to that of nontropical sprue

-HEMATOLOGICAL SYNDROME:thrombocytosis(>500,000 platelets/dl)can be observed in patients with cancer of lung,breast,GI or re3productive organs.

-CUTANEOUS SYNDROME:alopeciaa,herpes zoster, flushes, hypertrichosis, ichthyosis, acanthosis

-ENDOCRINE SYNDROMES:hyponatremia,hypercalcemia,hypoglycemia

-NEUROLOGICAL/NEUROMUSCULAR: paresthesias,tabetic like pain, acute hyporeflexia with reduction of proprioceptive sensitivity and ataxia

DIFFERENTIAL DIAGNOSIS:-Antiglomerular basement membrane disease,dementia, encephalopathy,encephalitis,myelitis,encephalomyelitis,acute glomerulonephritis,anemia,bone marrow failure,chronic fatigue syndrome,dermatomyositis,mixed connective tissue myelodysplastic syndrome

TREATMENT:- 1st therapeutic option surgery,radiation,chemotherapy,alone or in combination.2nd therapeutic option was immunosupression drugs like cyclosporin,antithymocyte globulin,corticosteroids .

yes i have experienced with this condition.