Case report: paraneoplastic cerebellar degeneration associated with anti-Yo antibody successfully treated with ofatumumab

Paraneoplastic cerebellar degeneration (PCD) with anti-Yo antibodies represents a rare immune-mediated paraneoplastic neurological syndrome. Its diagnosis and management remain clinically challenging. Here, we present a case of PCD with confirmed anti-Yo antibodies, validated through anti-cerebellar...

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Published inFrontiers in immunology Vol. 15; p. 1476397
Main Authors Dou, Jingjing, Yue, Xiaotong, Ren, Haitao, Wang, Chunjuan, Guo, Shougang
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 16.12.2024
Subjects
anti-Yo antibody
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Autoantibodies - blood
Autoantibodies - immunology
CD20
CDR2
CDR2L
Female
Humans
Immunology
Middle Aged
Nerve Tissue Proteins - immunology
ofatumumab
paraneoplastic cerebellar degeneration
Paraneoplastic Cerebellar Degeneration - diagnosis
Paraneoplastic Cerebellar Degeneration - drug therapy
Paraneoplastic Cerebellar Degeneration - immunology
Treatment Outcome
CD20
anti-Yo antibody
CDR2L
ofatumumab
CDR2
paraneoplastic cerebellar degeneration
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Summary:Paraneoplastic cerebellar degeneration (PCD) with anti-Yo antibodies represents a rare immune-mediated paraneoplastic neurological syndrome. Its diagnosis and management remain clinically challenging. Here, we present a case of PCD with confirmed anti-Yo antibodies, validated through anti-cerebellar degeneration protein 2 (CDR2) and anti-CDR2-like antibodies detection, which demonstrated a favorable response to ofatumumab therapy. The patient initially manifested with dizziness, nystagmus, dysarthria, and ataxia. Initial testing revealed weakly positive anti-Yo antibodies, accompanied by positive serum tissue-based assay result for cerebellum. Following one course of intravenous immunoglobulin and methylprednisolone pulse therapy, improvement of the patient’s dizziness was observed. Oral prednisone was prescribed for maintenance therapy. However, after discharge, the patient experienced progressive deterioration of symptoms, including worsening dizziness, dysarthria, and limb ataxia. Upon readmission to our hospital, further immunological testing confirmed the presence of anti-CDR2 and anti-CDR2-like antibodies. When a second course of methylprednisolone pulse therapy proved ineffective, treatment was switched to ofatumumab. After two doses, the patient achieved partial symptomatic relief.
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Hüsnü Efendi, Kocaeli University, Türkiye
Edited by: Gunnar Houen, University of Copenhagen, Denmark
Reviewed by: Akihiko Mitsutake, The University of Tokyo Hospital, Japan
ISSN:1664-3224
1664-3224
DOI:10.3389/fimmu.2024.1476397