Autoimmune paraneoplastic cerebellar degeneration in ovarian carcinoma patients treated with plasmapheresis and immunoglobulin: A case report

✍ Scribed by Yehuda Ben David; Ellen Warner; Maurice Levitan; David M. S. Sutton; Mark G. Malkin; Josep O. Dalmau

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 414 KB
• Volume: 78
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(19961115)78:10<2153::aid-cncr16>3.0.co;2-y

✦ Synopsis

BACKGROUND.

Paraneoplastic cerebellar degeneration (PCD) is a remote effect of cancer most frequently associated G t h carcinoma of the ovary or lung. In many patients, antibodies to Purkinje cells are found. Progressive, incapacitating cerebellar dysfunction occurs in most cases, and no treatment has produced even a transient response in any significant proportion of patients.

METHODS.

A woman age 81 years with recurrent ovarian carcinoma and PCD, confirmed clinically, radiologically, and serologically, was treated with 5 exchanges of 1 plasma volume each, followed by intravenous immunoglobulin at a dose of 1giKg-I body weight daily for 2 days.

RESULTS.

Several weeks after the treatment, the patient had significant improvement of her dizziness, tremor, and dysmetria. She refused maintenance therapy and began to deteriorate neurologically 3 months after the treatment.

CONCLUSIONS.

Although this is only a single case report, the authors believe that the dire prognosis of PCD and the lack of effective therapy warrant a trial of this combined treatment early in the course of the disease. Confirmatory evidence of the efficacy of such an approach would be welcomed.