Autoimmune myelopathy associated with collapsin response-mediator protein-5 immunoglobulin G.
Several autoimmune myelopathies are recognized clinically. We describe 57 patients in whom serological evaluation for myelopathy of uncertain cause demonstrated collapsin response-mediator protein 5 IgG. Most had spinal imaging and cerebrospinal fluid abnormalities and insidiously progressive presentation; some had acute monophasic or relapsing myelopathy. Initial diagnoses included multiple sclerosis, transverse myelitis, and unspecified neurodegenerative myelopathy. Most were smokers; neoplasia was discovered in 68% (most commonly small-cell lung carcinoma and after collapsin response-mediator protein-5 IgG detection). Collapsin response-mediator protein-5 autoimmune myelopathy and occult neoplasia are important considerations in patients with insidiously progressive myelopathy, especially with known cancer risk.
Keegan
B Mark
BM
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. keegan.bmark@mayo.edu
Pittock
Sean J
SJ
Lennon
Vanda A
VA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood / Q000134:cerebrospinal fluid; D015331:Cohort Studies; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D006867:Hydrolases; D007074:Immunoglobulin G / Q000096:biosynthesis* / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D008869:Microtubule-Associated Proteins; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D009419:Nerve Tissue Proteins / Q000276:immunology*; D013118:Spinal Cord Diseases / Q000150:complications* / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology
D001323:Autoantibodies; D007074:Immunoglobulin G; D008869:Microtubule-Associated Proteins; D009419:Nerve Tissue Proteins; C415087:DPYSL5 protein, human; D006867:Hydrolases