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Medline ® Abstract for Reference 70
of 'Chronic intestinal pseudo-obstruction'
70
PubMed
TIA novel approach to paraneoplastic intestinal pseudo-obstruction.
AUBadari A, Farolino D, Nasser E, Mehboob S, Crossland D
SOSupport Care Cancer. 2012;20(2):425.
Paraneoplastic neurologic syndromes (PNS) are
uncommon, affecting fewer than 1 in 10,000 patients with cancer. PNS, while rare, can cause significant
morbidity and impose enormous socio-economic costs, besides severely affecting quality of life. PNS can involve any part of the
nervous system and can present as
limbic encephalitis,
subacute cerebellar ataxias,
opsoclonus-myoclonus,
retinopathies,
chronic intestinal pseudo-obstruction (CIPO),
sensory neuronopathy,
Lambert-Eaton myasthenic syndrome,
stiff-person syndrome, and
encephalomyelitis. The
standard of care for CIPO includes the use of promotility and anti-secretory agents and the resection of the non-functioning gut segment; all of which can cause significant compromise in the quality of life. There is significant evidence that paraneoplastic neurologic syndromes are associated with
antibodies directed against certain
nerve antigens. [A patient was successfully treated] with CIPO in the setting of small cell lung cancer with a combination of
rituximab and
cyclophosphamide. The patient, who had failed to respond to
prokinetic agents,
anti-secretory therapy, and
multiple resections, responded to the
immunomodulatory therapy, with minimal residuals with PEG tube feeding and sustained ostomy output.
The use of rituximab and cyclophosphamide should therefore be considered in patients with CIPO, especially if it can
avoid complicated surgical procedures.
ADUniversity at Buffalo, Buffalo, NY, USA. badariar@gmail.com
PMID22072051
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