A new type of anti-Purkinje cell antibody (APCA) has been recently described in patients with paraneoplastic cerebellar degeneration preceding diagnosis of Hodgkin's disease. We present the case of a patient with PCD harbouring in his serum an APCA which led to the diagnosis of Hodgkin's disease. The patient developed a severe subacute onset cerebellar syndrome involving both trunk and limbs, with dysarthria, nystagmus and gait ataxia Brain MRI was normal. At immunohistochemistry an antibody producing granular aiaming oi me cytoplasm ana proximal dendntes of Hurkinje cells and diffuse staining of the molecular layer was detected at high titer (1/50,000). Immunoblots of isolated human Purkinje cells were negative. A total-body CT scan disclosed a retroperitoneal mass which resulted at pathological examination an Hodgkin's lymphoma. The patient was subsequently treated with chemotherapy and radiotherapy with total remission of Hodgkin's disease and partial remission of cerebellar syndrome. Lower antibody titer was detected at immunohistochemistry during this stage of the disease. High dose intravenous human IgG therapy did not produced any further improvement of the neurological signs. Better characterization of this APCA could help definition of a novel group of patients with paraneoplastic cerebellar degeneration preceding the diagnosis of Hodgkin's disease.
|Number of pages||1|
|Journal||Italian Journal of Neurological Sciences|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Clinical Neurology