Effective immunosuppressant therapy with cyclophosphamide and corticosteroids in paraneoplastic cerebellar degeneration.
Paraneoplastic cerebellar degeneration (PCD) is a rare immune mediated phenomenon often associated with cancer of the ovarian. Hitherto, tumor dissection is the mainstay in therapy while immunomodulatory treatment regimes often fail. Here we report on an 86 year old female patient who developed a severe pancerebellar syndrome. Clinical course, onconeural (anti-Yo) antibodies and detection of ovarian cancer suggest the assumption of PCD as the most probable diagnosis. We initiated a high-dose course of corticosteroids followed by a single dose of cyclophosphamide (600 mg/day). Surprisingly patient's condition improved and stabilized within days subsequent to cyclophosphamide application. This case demonstrates the benefit of immunosuppressive therapy in an anti-Yo positive patient with severe PCD secondary to an ovarian cancer.
Thöne
Jan
J
Department of Neurology, Clinical Center Nuernberg South, Breslauerstr. 201, 90471 Nuernberg, Germany. Jan_Thoene@gmx.de
Hohaus
Andreas
A
Lamprecht
Susanne
S
Bickel
Andreas
A
Erbguth
Frank
F
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000369:Aged, 80 and over; D000906:Antibodies / Q000378:metabolism; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009419:Nerve Tissue Proteins / Q000276:immunology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D020362:Paraneoplastic Cerebellar Degeneration / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods
D000305:Adrenal Cortex Hormones; D000906:Antibodies; C095184:CDR2 protein, human; D007166:Immunosuppressive Agents; D009419:Nerve Tissue Proteins; D003520:Cyclophosphamide