Demyelinating neuropathy with anti-CRMP5 antibodies predating diagnosis of breast carcinoma: favorable outcome after cancer therapy.

Abstract:

INTRODUCTION:Breast cancer is exceptionally associated with anti-collapsin response mediator protein 5 (anti-CRMP5) antibody or demyelinating neuropathy. This paraneoplastic antibody is itself not associated with demyelinating neuropathy. METHODS:Herein we describe a patient with a predominantly sensory ataxic demyelinating neuropathy associated with an IgG-kappa monoclonal gammopathy of uncertain significance (MGUS). Further investigations led to identification of anti-CRMP5 antibodies. An initial search for a malignancy proved negative. No immunomodulatory therapy was administered. RESULTS:The patient developed breast carcinoma 2 years after the initial neurological symptoms, which was effectively treated by surgery, chemotherapy, hormone therapy, and radiotherapy. At neurological follow-up, 16 months after cancer treatment, she remained in remission and had made substantial neurological recovery. Electrophysiology showed significant amelioration, and serum anti-CRMP5 antibodies were undetectable. MGUS paraprotein level was unchanged. CONCLUSION:This case widens the range of paraneoplastic manifestations of breast carcinoma to include anti-CRMP5 antibody-positive sensory ataxic demyelinating neuropathy, which, in this patient, improved after cancer treatment.

journal_name

Muscle Nerve

journal_title

Muscle & nerve

authors

Samarasekera S,Rajabally YA

doi

10.1002/mus.22036

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

764-6

issue

5

eissn

0148-639X

issn

1097-4598

journal_volume

43

pub_type

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