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Multifocal neuropathy as the presenting symptom of Purkinje cell cytoplasmic autoantibody‐1
Author(s) -
Bradshaw Michael J.,
Haluska Paul,
Mckeon Andrew,
Klein Christopher J.
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23936
Subject(s) - medicine , autoantibody , peripheral neuropathy , paraneoplastic cerebellar degeneration , pathology , ovarian cancer , exploratory laparotomy , malignancy , multifocal motor neuropathy , cancer , immunology , surgery , antibody , diabetes mellitus , mismatch negativity , endocrinology , electroencephalography , psychiatry
: 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. Muscle Nerve 48:827–831, 2013