{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T14:22:39Z","timestamp":1783606959616,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Paraneoplastic neurological syndromes associated with autoantibodies are rare diseases that cause abnormal manifestations of the nervous system. Early diagnosis of paraneoplastic neurological syndromes paves the way for prompt and efficient therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>we reported a 56-year-old man presenting with seizures and rapidly progressive cognitive impairment diagnosed as paraneoplastic limbic encephalitis (PLE) with anti-SRY-like high-mobility group box-1 (SOX-1) and anti-\u03b3-aminobutyric acid B (GABAB) receptor antibodies and finally confirmed by biopsy as small cell lung cancer (SCLC). At the first admission, brain magnetic resonance imaging (MRI) showed no abnormal signal in bilateral hippocampal regions and no abnormal enhancement of enhanced scan. The serum anti-GABAB receptor antibody was 1:100 and was diagnosed as autoimmune encephalitis (AE). The computed tomography (CT) scans of the chest showed no obvious tumor signs for the first time. Although positron emission tomography-computed tomography (PET-CT) revealed hypermetabolism in the para mid-esophageal, the patient and his family declined to undertake a biopsy. The patient improved after receiving immunoglobulin, antiepileptic therapy, and intravenous methylprednisolone (IVMP) pulse treatment. However, after 4 months, the symptoms reappeared. Brain MRI revealed abnormal signals in the hippocampal regions. Reexamination of the cerebral fluid revealed anti-GABAB receptor and anti-SOX-1 antibodies, which contributed to the diagnosis of PLE. SCLC was found in a para mid-esophageal pathological biopsy. Antiepileptic medications and immunoglobulin were used to treat the patient, and the symptoms were under control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings increase the awareness that patients with limbic encephalitis with cognitive dysfunction and epileptic seizures should be enhanced to detect latent malignancy. Our case also highlights the importance of anti-SOX1 antibodies in the detection of underlying neoplasm, particularly SCLC. Our findings raise awareness of the cognitive impairment seen by patients with limbic encephalitis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.955170","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T04:37:41Z","timestamp":1658983061000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Coexistence of anti-SOX1 and anti-GABAB receptor antibodies with paraneoplastic limbic encephalitis presenting with seizures and memory impairment in small cell lung cancer: A case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Sizhu","family":"Gong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enling","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyao","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70060-7","article-title":"Paraneoplastic syndromes of the CNS","volume":"7","author":"Dalmau","year":"2008","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.lungcan.2017.01.017","article-title":"Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature: Part 3: Neurological paraneoplastic syndromes, involving the central nervous system","volume":"106","author":"Bentea","year":"2017","journal-title":"Lung Canc"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2020-0080","article-title":"Diagnosis and treatment of limbic encephalitis in the cancer patient","volume":"16","author":"Kyritsis","year":"2020","journal-title":"Future Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1007\/s11912-018-0721-y","article-title":"Updates in the diagnosis and treatment of paraneoplastic neurologic syndromes","volume":"20","author":"Grativvol","year":"2018","journal-title":"Curr Oncol Rep"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/1941874418802130","article-title":"Cerebellar ataxia with extreme photophobia associated with anti-SOX1 antibodies","volume":"9","author":"Alessandro","year":"2019","journal-title":"Neurohospitalist"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2009.01.015","article-title":"SOX-1 autoantibodies in patients with paraneoplastic neurological syndromes","volume":"8","author":"Tschernatsch","year":"2009","journal-title":"Autoimmun Rev"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/21622965.2017.1392302","article-title":"Three case studies of nonparaneoplastic limbic encephalitis (NPLE) in young adult males: Onset, course, and recovery following rehabilitation services","volume":"8","author":"Perna","year":"2019","journal-title":"Appl Neuropsychol Child."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-228916","article-title":"A rare case of long-term paraesthesia diagnosed as a paraneoplastic syndrome by anti-SOX1 antibody determination","volume":"12","author":"Mirallas","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1708712","article-title":"Antibody-mediated encephalitis","volume":"378","author":"Dalmau","year":"2018","journal-title":"N Engl J Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2016.00037","article-title":"Detection and characterization of autoantibodies to neuronal cell-surface antigens in the central nervous system","volume":"9","author":"van Coevorden-Hameete","year":"2016","journal-title":"Front Mol Neurosci"},{"key":"B11","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.autrev.2013.10.016","article-title":"Molecular and cellular mechanisms underlying anti-neuronal antibody mediated disorders of the central nervous system","volume":"13","author":"van Coevorden-Hameete","year":"2014","journal-title":"Autoimmun Rev"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1006\/mcne.2001.0995","article-title":"Epileptogenesis and enhanced prepulse inhibition in GABA(B1)-deficient mice","volume":"17","author":"Prosser","year":"2001","journal-title":"Mol Cell Neurosci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/S0896-6273(01)00345-2","article-title":"Epilepsy, hyperalgesia, impaired memory, and loss of pre- and postsynaptic GABA(B) responses in mice lacking GABA(B(1))","volume":"31","author":"Schuler","year":"2001","journal-title":"Neuron."},{"key":"B14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/S1474-4422(09)70324-2","article-title":"Antibodies to the GABA(B) receptor in limbic encephalitis with seizures: case series and characterisation of the antigen","volume":"9","author":"Lancaster","year":"2010","journal-title":"Lancet Neurol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00403","article-title":"Clinical characteristics of anti-GABA-B receptor encephalitis","volume":"11","author":"Zhu","year":"2020","journal-title":"Front Neurol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/apm.12543","article-title":"SOX1 inhibits breast cancer cell growth and invasion through suppressing the wnt\/\u03b2-catenin signaling pathway","volume":"124","author":"Song","year":"2016","journal-title":"APMIS."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2020.16.4.530","article-title":"Anti-SOX1 antibodies in paraneoplastic neurological syndrome","volume":"16","author":"Sun","year":"2020","journal-title":"J Clin Neurol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000281663.81079.24","article-title":"SOX1 antibodies are markers of paraneoplastic Lambert-Eaton myasthenic syndrome","volume":"70","author":"Sabater","year":"2008","journal-title":"Neurology."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-235668","article-title":"Paraneoplastic subacute sensory neuropathy with triple positive antineuronal antibodies associated with small-cell lung cancer","volume":"13","author":"Hean","year":"2020","journal-title":"BMJ Case Rep"},{"key":"B20","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/1750-1172-2-22","article-title":"Paraneoplastic neurological syndromes","volume":"2","author":"Honnorat","year":"2007","journal-title":"Orphanet J Rare Dis"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2015.11.016","article-title":"Intrathecal synthesis of onconeural antibodies in patients with paraneoplastic syndromes","volume":"290","author":"Corsini","year":"2016","journal-title":"J Neuroimmunol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1212\/01.CON.0000413664.42798.aa","article-title":"Paraneoplastic disorders of the CNS and autoimmune synaptic encephalitis","volume":"18","author":"Rosenfeld","year":"2012","journal-title":"Continuum (Minneap Minn)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000542","article-title":"Paraneoplastic disorders","volume":"23","author":"Lancaster","year":"2017","journal-title":"Continuum (Minneap Minn)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.4161\/epi.20219","article-title":"Key epigenetic changes associated with lung cancer development: Results from dense methylation array profiling","volume":"7","author":"Nelson","year":"2012","journal-title":"Epigenetics."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a9585f","article-title":"Encephalitis and GABAB receptor antibodies: Novel findings in a new case series of 20 patients","volume":"81","author":"H\u00f6ftberger","year":"2013","journal-title":"Neurology."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2005.03.020","article-title":"Anti-glial nuclear antibody: Marker of lung cancer-related paraneoplastic neurological syndromes","volume":"165","author":"Graus","year":"2005","journal-title":"J Neuroimmunol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2017.1395125","article-title":"Assessment of neuronal autoantibodies in patients with small cell lung cancer treated with chemotherapy with or without ipilimumab","volume":"7","author":"Hardy-Werbin","year":"2018","journal-title":"Oncoimmunology."},{"key":"B28","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s00401-011-0876-1","article-title":"Paraneoplastic encephalomyelopathies: pathology and mechanisms","volume":"122","author":"McKeon","year":"2011","journal-title":"Acta Neuropathol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-0652","article-title":"Neural autoantibody clusters aid diagnosis of cancer","volume":"20","author":"Horta","year":"2014","journal-title":"Clin Cancer Res"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21088","article-title":"Frequency of SOX group b (SOX1, 2, 3) and ZIC2 antibodies in Turkish patients with small cell lung carcinoma and their correlation with clinical parameters","volume":"103","author":"Vural","year":"2005","journal-title":"Cancer."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2017.03.005","article-title":"Paraneoplastic limbic encephalitis with SOX1 and PCA2 antibodies and relapsing neurological symptoms in an adolescent with Hodgkin lymphoma","volume":"21","author":"Kunstreich","year":"2017","journal-title":"Eur J Paediatr Neurol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.955170\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T04:37:44Z","timestamp":1658983064000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.955170\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":31,"alternative-id":["10.3389\/fimmu.2022.955170"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.955170","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,28]]},"article-number":"955170"}}