A paraneoplastic syndrome is a group of symptoms arising due to the presence of tumor in the body which may be known or yet to be detected. It is a collection of various diverse types of symptoms occurring away from the site of tumor or cancer.
Who Is At Risk For Paraneoplastic Syndrome?
The patients suffering from various different cancers have the risk of developing the paraneoplastic syndrome. If the patient is suffering from multiple cancers at the same time then the risk becomes very high. According to an analysis, among all the patients suffering from all types of cancers, nearly 8% of them are known to develop paraneoplastic syndrome[1].
Immunocompromised people who are on chemotherapy or radiotherapy treatment are having more risk to develop paraneoplastic syndrome because of the inability of the body to fight and recover from the external damage occurring to normal cells with the therapy.
Autoimmune reactions and history of allergy also predispose the person to the risk of getting a paraneoplastic syndrome already suffering from the underlying cancerous condition.
Patients suffering from hematological cancers involving various blood cell cancers and primary or secondary lymphoid organs and lung cancers are known to be more prone to develop paraneoplastic syndrome because of development of the various types of antibodies and immunocompetent cells which cross-reacts with cells of other organs without recognizing them for self or non-self and attacks them. These results in symptoms occurring related to the secondary organ involved after the autoimmune destruction and hence causing the paraneoplastic syndrome.
Is There A Blood Test For It?
Approach For The Testing Of Paraneoplastic Syndrome
In cases suspected with paraneoplastic syndrome, complete workup of blood, urine and cerebrospinal fluid is done. Besides these, other tests depending on the organ involvement are done to determine the damage. Autoimmune antibody assays which are a sophisticated form of blood tests are also done in the workup to determine the cause and source of autoimmunity.
Various blood tests are done for detection of paraneoplastic syndrome. For anemia, the complete blood cell count is done. White blood cell count to diagnose lymphoma or leukemia. Hypereosinophilia is seen in Hodgkin lymphoma. Platelet count of done for disseminated intravascular coagulation. Erythrocyte sedimentation rate is also found to be elevated in cancers and paraneoplastic syndrome.
In paraneoplastic syndrome affecting the liver, alanine and aspartate transaminase are found to be raised. Sometimes, alkaline phosphatase and lactate dehydrogenase are also raised in cases of obstruction to the path of bile output. These can also be raised in bone malignancies and bone tumors. Also can be raised in orthopedics paraneoplastic[2].
Usually, various tumor markers specific for cancers are measured in blood like carcinoembryonic antigen is raised in gastrointestinal and breast tumors. The prostate-specific antigen is raised in either prostate cancer or the paraneoplastic syndrome. CA19-9 marker is raised in patients affected with pancreatic paraneoplastic syndrome. CA125 cancer marker is detected in paraneoplastic, metastasis, and cancers of female genital tract like uterus, ovaries, cervix, etc. It is also detected via an assay done in a blood sample.
Tests for autoantibodies are also done to detect the source of paraneoplastic origin and to confirm it. Various assays are done for autoantibodies in the cases where the paraneoplastic syndrome is affecting the neurological component of the patient.
Conclusion
The patients suffering from cancers are all at risk for paraneoplastic syndrome. Although there is only a few numbers of cases actually suffering from it. It may range from trivial and nonspecific to the dangerous and specific paraneoplastic syndrome. Immunosuppression remains a large risk factor for the development of the paraneoplastic syndrome. Autoimmunity is one of the other major risk factor involved in paraneoplastic syndrome. Usually whole of the blood workup becomes necessary in the suspected cases but some specific tests to diagnose the syndrome are done at times. Early findings and reporting of even trivial symptoms should be reported immediately and suspiciousness of the paraneoplastic syndrome should be either confirmed or ruled out.
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