Abstract:
RATIONALE:Paraneoplastic cerebellar degeneration (PCD) is a rare neurodegenerative syndrome associated with antibodies targeting the Purkinje cells of the cerebellum. Most cases of anti-Yo-associated PCD occur in females, with <20 cases reported in males. Herein, we report a male patient with anti-Yo-associated PCD who was treated with plasma exchange and achieved a favorable outcome. PATIENT CONCERNS:A 64-year-old man presented with progressive ataxia, gait instability, and dysuria. Electroencephalography, electromyography, brain and spinal neuroimaging, and routine laboratory examinations were all normal. The anti-neuronal antibody Anti-Yo was detected in the serum but not in the cerebrospinal fluid (CSF). DIAGNOSIS:The patient was diagnosed with definite anti-Yo-associated PCD based on the clinical manifestations, anti-Yo was detected in the serum and response to treatment. INTERVENTIONS:At beginning, the patient was treated with dexamethasone (10 mg/day for 10 days). Then, plasma exchange was performed. OUTCOMES:After treated with dexamethasone, no clinical improvement was noted in this patient. In the following month, his condition deteriorated. However, after two courses of plasma exchange, neurological examination showed marked improvement in gait. After four courses of plasma exchange, the patient could walk independently, the Romberg test was negative, and anti-Yo antibodies were undetectable. At the 6-month follow-up, the patients' symptoms were relieved, and tests for anti-Yo antibodies remained negative. LESSONS SUBSECTIONS:Treatment with plasma exchange for anti-Yo-associated male PCD patients without a concomitant tumor are recommend and need more studies.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Hu FQ,Shang FR,Liu JJ,Yuan Hdoi
10.1097/MD.0000000000021760subject
Has Abstractpub_date
2020-08-14 00:00:00pages
e21760issue
33eissn
0025-7974issn
1536-5964pii
00005792-202008140-00104journal_volume
99pub_type
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