Paraneoplastic Anti-Tif1-gamma Autoantibody-positive Dermatomyositis as Clinical Presentation of Hepatocellular Carcinoma Recurrence.
Marco FerronatoClaudine LalanneChiara QuarnetiMichele CevolaniChiara RicciAlessandro GranitoLuigi MuratoriMarco LenziPublished in: Journal of clinical and translational hepatology (2022)
Hepatocellular carcinoma (HCC) is rarely associated with autoimmune paraneoplastic syndromes. We report a case of anti-transcriptional intermediary factor-1 gamma (TIF1-γ)-positive dermatomyositis (DM) as clinical presentation of HCC recurrence in a 72-year-old male patient admitted to our hospital due to fatigue, myalgia, and typical skin rash. His medical history was notable for hepatitis C-related cirrhosis, successful treatment with direct-acting antiviral agents, and previously efficacious treatment of HCC. Laboratory testing showed significant rhabdomyolysis with anti-TIF1-γ antibodies at high titer, and DM was diagnosed. After a careful diagnostic workup, HCC recurrence was diagnosed. After first-line corticosteroid treatment, azathioprine and intravenous immunoglobulin treatments were administered; unfortunately, he mounted only partial response. Owing to the compromised performance status, no HCC treatment was feasible, and, according to international guidelines, he received only best supportive care. Here, we discuss the diagnostic, prognostic, and pathogenic roles of anti-TIF1-γ antibodies associated with paraneoplastic DM and the scant literature data on its occurrence in HCC patients. Considering the TIF1 gene family's established role in oncogenesis, we also review the role of TIF1-γ as a tumor-related neoantigen, leading to the development of clinically overt anti-TIF1-γ antibodies-positive DM.
Keyphrases
- healthcare
- systematic review
- gene expression
- end stage renal disease
- type diabetes
- emergency department
- acute kidney injury
- ejection fraction
- systemic lupus erythematosus
- multiple sclerosis
- metabolic syndrome
- free survival
- interstitial lung disease
- quality improvement
- machine learning
- high dose
- insulin resistance
- disease activity
- adipose tissue
- chronic pain
- glycemic control
- depressive symptoms
- electronic health record
- skeletal muscle
- sleep quality