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Nicotinic ganglionic acetylcholine receptor autoantibodies associated with paraneoplastic disease in a neuropsychiatric patient
  1. Catherine Stauffer1,2,
  2. Daniel A Llano3 and
  3. Suzanna Kitten4
  1. 1Carle Foundation Hospital, Urbana, Illinois, USA
  2. 2Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
  3. 3Carle Neuroscience Institute, Carle Foundation Hospital, Urbana, Illinois, USA
  4. 4Psychiatry, Carle Foundation Hospital, Urbana, Illinois, USA
  1. Correspondence to Ms Catherine Stauffer; ces10{at}illinois.edu

Abstract

Nicotinic ganglionic acetylcholine receptor autoantibodies (alpha-3-AChR Ab) are associated with paraneoplastic syndromes when present in low elevations. These antibodies can be tested for as part of an autoimmune encephalopathy panel in neuropsychiatric patients; a mildly elevated titre of alpha-3-AChR Ab that may start as an incidental finding can lead to the diagnosis of a previously undetected cancer. While alpha-3-AChR Ab are most typically associated with thymomas and small cell lung cancer, the presence of these antibodies can suggest a diverse range of other cancers. This case presents a patient with longstanding neuropsychiatric symptoms and possible functional hypothyroidism for whom a low elevation in alpha-3-AChR Ab led to the finding of papillary thyroid carcinoma.

  • mood disorders (including depression)
  • endocrine cancer
  • screening (oncology)
  • neuroendocrinology
  • anxiety disorders (including OCD and PTSD)

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Footnotes

  • Contributors CS completed a chart review and prepared the manuscript draft. SK treated the patient, proposed the case review, lent medical expertise and contributed to drafting and revising the manuscript. DAL was involved in patient care and advised on neurological aspects of the case as well as contributed to the writing and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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