title: Isolated ZIC4 antibodies in paraneoplastic cerebellar syndrome with an underlying ovarian tumor.
abstract: OBJECTIVE
  To describe a patient with paraneoplastic cerebellar syndrome and the uncommon association of isolated ZIC4 antibodies and ovarian cancer.
  
  
  METHODS
  Case report and review of the literature.
  
  
  METHODS
  Hospitalized care, follow-up in private practice.
  
  
  METHODS
  A 60-year-old woman with severe paraneoplastic cerebellar syndrome and an underlying ovarian adenocarcinoma.
  
  
  METHODS
  Neurological examination, lumbar puncture, laboratory tests, radiological imaging, and histological examination.
  
  
  METHODS
  Clinical course and titer of anti- ZIC4 antibodies in serum.
  
  
  RESULTS
  Laboratory and cerebrospinal fluid tests revealed the isolated presence of ZIC4 antibodies. Screening results for small cell lung carcinoma were negative, while abdominal computed tomographic scan was suggestive of ovarian adenocarcinoma, which was confirmed by histological examination. Glucocorticosteroid administration and chemotherapy led to complete remission of paraneoplastic cerebellar degeneration.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first case of paraneoplastic cerebellar degeneration in a patient with isolated ZIC4 antibodies associated with ovarian adenocarcinoma.
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Germany.
authors.forename: Antonios
authors.initials: A
authors.lastname: Kerasnoudis
authors.forename: Milena
authors.initials: M
authors.lastname: Rockhoff
authors.forename: Jens
authors.initials: J
authors.lastname: Federlein
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.forename: Christos
authors.initials: C
authors.lastname: Krogias
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001323:Autoantibodies / Q000096:biosynthesis / Q000097:blood*; D002524:Cerebellar Ataxia / Q000209:etiology / Q000503:physiopathology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology*; D010051:Ovarian Neoplasms / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D020362:Paraneoplastic Cerebellar Degeneration / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D014157:Transcription Factors / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D009419:Nerve Tissue Proteins; D014157:Transcription Factors; C492799:ZIC4 protein, human