title: Case report: low-titre anti-Yo reactivity in a female patient with psychotic syndrome and frontoparieto-cerebellar atrophy.
abstract: BACKGROUND
  Autoimmune and inflammatory mechanisms in psychotic disorders have attracted increasing scientific attention in recent years. In this regard, we performed routine cerebrospinal fluid (CSF) basic diagnostics and CSF/serum analyses for antibodies directed against neuronal intracellular and surface antigens in psychotic patients. In this context, the patient presented in this paper was diagnosed.
  
  
  METHODS
  We present the case of a 20-year-old female patient with a first episode of a drug-induced psychotic syndrome but without neurological deficits. Further investigations showed a reproducible low-titre positive anti-Yo reactivity in the CSF and serum with two independent immunoblot assays. Magnetic resonance imaging showed frontoparietal and cerebellar atrophy. On [(18)F]fluorodeoxyglucose positron emission tomography, a mild cerebellar hypometabolism was found. No underlying tumor was detected.
  
  
  CONCLUSIONS
  Despite the presence of anti-Yo reactivity, the diagnostic criteria for a paraneoplastic neurological syndrome were not fulfilled. Previously published data indicate the possible association between low-titer antibodies against intracellular localized, onconeural antigens, and psychotic disorders. Large prospective studies that investigate the prevalence and clinical significance of antibodies against intracellular onconeural antigens in psychiatry are needed.
authors.affiliation: Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, 79104, Freiburg, Germany. dominique.endres@uniklinik-freiburg.de.
authors.forename: Dominique
authors.initials: D
authors.lastname: Endres
authors.affiliation: Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, 79104, Freiburg, Germany. evgeniy.perlov@uniklinik-freiburg.de.
authors.forename: Evgeniy
authors.initials: E
authors.lastname: Perlov
authors.affiliation: Department of Neurology, University Medical Center Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany. oliver.stich@uniklinik-freiburg.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Stich
authors.affiliation: Department of Nuclear Medicine, University Medical Center Freiburg, Hugstettet Str. 64, 79106, Freiburg, Germany. philipp.meyer@uniklinik-freiburg.de.
authors.forename: Philipp Tobias
authors.initials: PT
authors.lastname: Meyer
authors.affiliation: Department of Neuroradiology, University Medical Center Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany. niklas.luetzen@uniklinik-freiburg.de.
authors.forename: Niklas
authors.initials: N
authors.lastname: Lützen
authors.affiliation: Section for Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, 79104, Freiburg, Germany. tebartzvanelst@uniklinik-freiburg.de.
authors.forename: Ludger
authors.initials: L
authors.lastname: Tebartz van Elst
mesh_terms: D001284:Atrophy; D002531:Cerebellum / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009419:Nerve Tissue Proteins / Q000097:blood / Q000134:cerebrospinal fluid; D020361:Paraneoplastic Syndromes, Nervous System / Q000175:diagnosis*; D010296:Parietal Lobe / Q000378:metabolism / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000276:immunology; D019275:Radiopharmaceuticals; D055815:Young Adult
chemical_list: C095184:CDR2 protein, human; D009419:Nerve Tissue Proteins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18