Multifocal neuropathy as the presenting symptom of Purkinje cell cytoplasmic autoantibody-1

Michael J. Bradshaw, Paul Haluska, Andrew B McKeon, Christopher Jon Klein

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Patients with Purkinje cell cytoplasmic autoantibody type 1 (PCA-1-IgG, a.k.a. anti-Yo) classically present with a paraneoplastic syndrome characterized by subacute onset cerebellar ataxia with rapid progression. Recently, a broader spectrum of neurological presentations has been recognized, which include peripheral neuropathy, but detailed case descriptions are lacking. Methods: A patient presented with a painful progressive multifocal sensorimotor polyneuropathy including face pain. Whole body positron emission tomography (PET), exploratory abdominal laparotomy and nerve biopsy were combined with serial neurological examinations and neuro-immunological testing to diagnose and determine treatment. Results: PCA-1 autoimmunity was identified. Although a PET scan failed to detect a tumor, the patient underwent an exploratory laparotomy, given the strong association of PCA-1-IgG autoantibodies with underlying malignancy. The patient was diagnosed with an ovarian lymphoepithelial cancer that was subsequently treated with chemotherapy. Conclusions: PCA-1-IgG autoantibodies can occur in the setting of peripheral neuropathy and predict type of cancer. Multifocal neuropathy with face pain and treatment-resistance is a specific clinical pattern associated with PCA-1-IgG autoantibodies and ovarian cancer.

Original languageEnglish (US)
Pages (from-to)827-831
Number of pages5
JournalMuscle and Nerve
Volume48
Issue number5
DOIs
StatePublished - Nov 2013

Fingerprint

Passive Cutaneous Anaphylaxis
Purkinje Cells
Autoantibodies
Facial Pain
Immunoglobulin G
Peripheral Nervous System Diseases
Positron-Emission Tomography
Ovarian Neoplasms
Laparotomy
Paraneoplastic Syndromes
Neoplasms
Cerebellar Ataxia
Polyneuropathies
Neurologic Examination
Autoimmunity
Biopsy
Drug Therapy
Therapeutics

Keywords

  • Anti-Yo
  • Cerebellar degeneration
  • Paraneoplastic
  • PCA-1
  • Peripheral neuropathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)
  • Physiology

Cite this

Multifocal neuropathy as the presenting symptom of Purkinje cell cytoplasmic autoantibody-1. / Bradshaw, Michael J.; Haluska, Paul; McKeon, Andrew B; Klein, Christopher Jon.

In: Muscle and Nerve, Vol. 48, No. 5, 11.2013, p. 827-831.

Research output: Contribution to journalArticle

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