title: [Anti-amphiphysin antibody-positive paraneoplastic neurological syndrome with a longitudinally extensive spinal cord lesion of the dorsal column].
abstract: A 53-year-old woman was admitted to our hospital because of gait disturbance and paresthesia of the lower extremities. She also had marked deep sense impairment in her lower limbs. Cervical MRI showed a longitudinally extensive spinal cord lesion of the dorsal column at levels C1-T11. The findings of cerebrospinal fluid examination, including the IgG index (0.65), were normal. Serum anti-AQP4 antibody was negative, but anti-amphiphysin antibody was positive. Electrophysiological examinations suggested the presence of lesions in the dorsal column of the spinal cord and dorsal root ganglion (DRG). Enlargement of and fluorodeoxyglucose accumulation in her left parasternal lymph node was observed on contrast-enhanced CT and PET-CT, respectively. The lymph node biopsy was underwent by using thoracoscopy. The metastasis of carcinoma was pathologically confirmed. Although the primary tumor was not detected on PET-CT re-examination, immunostaining of the biopsied lymph node specimen was positive for both the progesterone receptor and estrogen receptor. On the basis of these findings, the patient was diagnosed with paraneoplastic neurological syndrome due to potential breast cancer. The disorder is an immunological subacute sensory neuropathy with a longitudinally extensive spinal cord lesion of the dorsal column and a DRG lesion.
authors.affiliation: Department of Neurology, Brain Attack Center Ota Memorial Hospital.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Neshige
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Takeshima
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Shimoe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Masaru
authors.initials: M
authors.lastname: Kuriyama
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005727:Ganglia, Spinal; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology*; D020361:Paraneoplastic Syndromes, Nervous System / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D014855:Wallerian Degeneration / Q000175:diagnosis / Q000209:etiology*
chemical_list: D001323:Autoantibodies; D009419:Nerve Tissue Proteins; C075637:amphiphysin