Paraneoplastic cerebellar degeneration with anti‐Yo antibody in a man

Abstract

anisms of the disease.Five of the 15 patients initially treated with steroids with or without other immunosuppressors deteriorated during the treatment.'^^^^ Although these data may suggest that immunosuppressor therapy is not effective in this disorder, the rapid improvement of patient 2 i n our study with intravenous immunoglobulins would support another explanation; a s in rapidly progressive myasthenia gravis, the standard oral immunosuppressor therapy does not act fast enough to prevent the usually subacute progression of the disorder. In a previous patient, the treatment with immunoglobulins did not change the progression of the disease, but the patient was reported in an abstract and the dose of immunoglobulins and the time when the treatment was given are not known.7In conclusion, the good response of patient 2 in our study to high-dose intravenous immunoglobulins suggest that this treatment should be tried in other patients with this syndrome. References 1. Susac JO, Hardimann JM, Selhorst JB. Microangiopathy of the brain and retina. Neurology 1979;29:313-316. 2. Susac JO. Susac's syndrome: the triad of microangiopathy of the brain and retina with hearing loss in young women. Neurology 1994;44:591-593. 3. Kaminska EA, Sadler M, Sangalang V, Hoskinmott A, Silverberg D. Microangiopathic syndrome of encephalopathy, retinal vessel occlusion, and hearing loss [abstract]. Can J Neurol Sci 1990;17:241. 4. Monteiro MLR, Swanson RA, Coppeto JR, Cuneo RA, DeArmond SJ, Prusiner SB. A microangiopathic syndrome of encephalopathy, hearing loss, and retinal arteriolar occlusions. Neurology 1985;35:1113-1121. 5. Bogousslavsky J, Gaio J-M, Caplan LR, et al. Encephalopathy, deafness and blindness in young women: a distinct retinocochleocerebral arteriopathy? J Neurol Neurosurg Psychiatry 1989;52:43-46. 6. Petty GW, Yanagihara T, Bartleson JD, Younge BR, Mokri B. Retinoeochleocerebral vasculopathy [abstract]. Ann Neurol 1991;30:245. 7. Manor RS, Ouaknine L, Ouaknine G. Susac-RED syndrome [abstract].

The immunopathogenesis of paraneoplastic neurological syndromes

“…In patients presenting with a paraneoplastic syndrome manifesting predominantly as cerebellar dysfunction the most frequently detected antiPurkinje cell antibody reacts with an antigen termed Yo or cdr2 (cerebellar degeneration related 2) [27,28]. AntiYo antibodies are usually found in female patients with cerebellar dysfunction [29], with only three reported cases of anti-Yo antibody detection in similarly affected males [30][31][32]. Gynaecological and breast malignancies are the usual tumour associations in females [29], whereas all the three male cases had adenocarcinomas (oesophageal, parotid, unknown primary) [32].…”

Anti-Yo-Associated Paraneoplastic Cerebellar Degeneration in a Man with Adenocarcinoma of the Gastroesophageal Junction

“…To the best of our knowledge, only 7 male patients with anti-Yo-associated PCD have been described so far [4, 5,8,9,10,11,12]. Including our patient, 5 had an underlying gastrointestinal adenocarcinoma (3 esophageal [4, 5] and 2 gastric [9, 12]).…”

“…Including our patient, 5 had an underlying gastrointestinal adenocarcinoma (3 esophageal [4, 5] and 2 gastric [9, 12]). The other 3 had adenocarcinoma of the parotid gland [8], lung [11] or of unknown origin [10]. …”

Extracts of lung cancer cells reveal antitumour antibodies in sera of patients with lung cancer

“…In particular, several paraneoplastic antigens are described to be associated with SCLC that can cause early development of the corresponding neurological syndromes mediated by antibodies against these antigens [1]. There are data that neurological syndromes may appear months or even years before the cancer becomes evident [4,[11][12][13]. Although the detection of both the antigens and the corresponding antibodies in sera can be indicative of the presence of SCLC in patients, it should be remembered that, as a rule, no individual marker appears to be of major clinical importance that calls for the use of panels of markers [14].…”