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Sarah Lee - One of the best experts on this subject based on the ideXlab platform.
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paraneoplastic cerebellar degeneration with castleman disease a case report p1 027
Neurology, 2014Co-Authors: Sarah LeeAbstract:OBJECTIVE: To report the first case of paraneoplastic cerebellar degeneration with Castleman disease. BACKGROUND: Paraneoplastic Cerebellar Degeneration (PCD) is a rare syndrome that has been previously associated with small cell lung cancer, gynecologic cancers, and Hodgkin lymphoma. Though multiple autoantibodies have been implicated, CSF/serum testing can be negative and symptoms often precede cancer detection, making prompt diagnosis a challenge. Castleman disease is a heterogeneous lymphoproliferative disorder which has associations with HHV-8, POEMS syndrome and paraneoplastic pemphigus. On review of current literature, there have been no prior case reports of PCD with Castleman disease. DESIGN/METHODS: Case report and literature review. RESULTS: A 30-year-old, previously healthy male pastor presented with a one-month history of progressive vertigo, ataxia and Speech changes. On exam, he had severe nystagmus, Scanning Speech and profound axial and appendicular ataxia. Enhancement in the cerebellar fissures was seen on MRI, and CSF studies revealed lymphocytosis. Paraneoplastic panels sent from both CSF and serum were negative, as were CSF oligoclonal bands and extensive bacterial, fungal and viral studies (including EBV, VZV, HSV, Lyme, Coxsackie, enterovirus, HHV-8, HIV). Serum IL-6 was mildly elevated at 26. Due to concern for a paraneoplastic process, CT of the chest, abdomen and pelvis was done and showed multiple anterior mediastinal soft tissue nodules that were metabolically active on subsequent PET scan. Pathology results from lymph node biopsy confirmed the diagnosis of hyaline vascular Castleman disease. The patient was treated with steroids, IVIG and subsequent resection of the mass. Follow-up MRI showed resolution of cerebellar enhancement and the patient experienced some improvement, though was still significantly impaired at 3-month follow-up. CONCLUSIONS: Although a specific autoantibody was not identified, the rarity of both Castleman disease and cerebellar degeneration, in conjunction with the well-described neoplastic and paraneoplastic associations of both, strongly suggests a relationship not previously described. Disclosure: Dr. Lee has nothing to disclose. Dr. Le has nothing to disclose.
Josep Dalmau - One of the best experts on this subject based on the ideXlab platform.
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anti yo associated paraneoplastic cerebellar degeneration in a man with adenocarcinoma of unknown origin
Neurology, 1996Co-Authors: John W Krakauer, Casilda Balmaceda, J T Gluck, Jerome B Posner, M R Fetell, Josep DalmauAbstract:Anti-Yo-associated paraneoplastic cerebellar degeneration (PCD) is almost invariably associated with breast or gynecologic tumors. 1 In this syndrome, anti-Yo autoantibodies react with 34- and 62-kd antigens simultaneously expressed by tumor and Purkinje cells. 2 Using immunohistochemistry, similar staining (although not always identical) antibodies have been found and named by others PCA-1 and type I antineuronal antibodies. 3 Only one male patient, in whom no tumor was found, has been reported with anti-Yo-associated PCD. 4 We report another man with anti-Yo-associated PCD in the context of a carcinoma of unknown origin. A nonenzymatic method to unmask antigens in paraffin-embedded tissue helped to demonstrate that the tumor expressed Yo antigens. A 68-year-old right-handed man with a medical history of heavy tobacco and alcohol use presented to the neurology clinic with a 2-month history of progressively unsteady gait and frequent falls. He denied heavy alcohol use over this period. On physical examination he had gynecomastia and normal male genitalia except for an undescended testis. There was severe bilateral dysmetria involving only the legs, without weakness or sensory loss. A repeat examination 1 month later demonstrated progression of symptoms. It also showed dysarthria with Scanning Speech, multidirectional gaze-evoked nystagmus, …
John W Krakauer - One of the best experts on this subject based on the ideXlab platform.
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anti yo associated paraneoplastic cerebellar degeneration in a man with adenocarcinoma of unknown origin
Neurology, 1996Co-Authors: John W Krakauer, Casilda Balmaceda, J T Gluck, Jerome B Posner, M R Fetell, Josep DalmauAbstract:Anti-Yo-associated paraneoplastic cerebellar degeneration (PCD) is almost invariably associated with breast or gynecologic tumors. 1 In this syndrome, anti-Yo autoantibodies react with 34- and 62-kd antigens simultaneously expressed by tumor and Purkinje cells. 2 Using immunohistochemistry, similar staining (although not always identical) antibodies have been found and named by others PCA-1 and type I antineuronal antibodies. 3 Only one male patient, in whom no tumor was found, has been reported with anti-Yo-associated PCD. 4 We report another man with anti-Yo-associated PCD in the context of a carcinoma of unknown origin. A nonenzymatic method to unmask antigens in paraffin-embedded tissue helped to demonstrate that the tumor expressed Yo antigens. A 68-year-old right-handed man with a medical history of heavy tobacco and alcohol use presented to the neurology clinic with a 2-month history of progressively unsteady gait and frequent falls. He denied heavy alcohol use over this period. On physical examination he had gynecomastia and normal male genitalia except for an undescended testis. There was severe bilateral dysmetria involving only the legs, without weakness or sensory loss. A repeat examination 1 month later demonstrated progression of symptoms. It also showed dysarthria with Scanning Speech, multidirectional gaze-evoked nystagmus, …
Casilda Balmaceda - One of the best experts on this subject based on the ideXlab platform.
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anti yo associated paraneoplastic cerebellar degeneration in a man with adenocarcinoma of unknown origin
Neurology, 1996Co-Authors: John W Krakauer, Casilda Balmaceda, J T Gluck, Jerome B Posner, M R Fetell, Josep DalmauAbstract:Anti-Yo-associated paraneoplastic cerebellar degeneration (PCD) is almost invariably associated with breast or gynecologic tumors. 1 In this syndrome, anti-Yo autoantibodies react with 34- and 62-kd antigens simultaneously expressed by tumor and Purkinje cells. 2 Using immunohistochemistry, similar staining (although not always identical) antibodies have been found and named by others PCA-1 and type I antineuronal antibodies. 3 Only one male patient, in whom no tumor was found, has been reported with anti-Yo-associated PCD. 4 We report another man with anti-Yo-associated PCD in the context of a carcinoma of unknown origin. A nonenzymatic method to unmask antigens in paraffin-embedded tissue helped to demonstrate that the tumor expressed Yo antigens. A 68-year-old right-handed man with a medical history of heavy tobacco and alcohol use presented to the neurology clinic with a 2-month history of progressively unsteady gait and frequent falls. He denied heavy alcohol use over this period. On physical examination he had gynecomastia and normal male genitalia except for an undescended testis. There was severe bilateral dysmetria involving only the legs, without weakness or sensory loss. A repeat examination 1 month later demonstrated progression of symptoms. It also showed dysarthria with Scanning Speech, multidirectional gaze-evoked nystagmus, …
J T Gluck - One of the best experts on this subject based on the ideXlab platform.
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anti yo associated paraneoplastic cerebellar degeneration in a man with adenocarcinoma of unknown origin
Neurology, 1996Co-Authors: John W Krakauer, Casilda Balmaceda, J T Gluck, Jerome B Posner, M R Fetell, Josep DalmauAbstract:Anti-Yo-associated paraneoplastic cerebellar degeneration (PCD) is almost invariably associated with breast or gynecologic tumors. 1 In this syndrome, anti-Yo autoantibodies react with 34- and 62-kd antigens simultaneously expressed by tumor and Purkinje cells. 2 Using immunohistochemistry, similar staining (although not always identical) antibodies have been found and named by others PCA-1 and type I antineuronal antibodies. 3 Only one male patient, in whom no tumor was found, has been reported with anti-Yo-associated PCD. 4 We report another man with anti-Yo-associated PCD in the context of a carcinoma of unknown origin. A nonenzymatic method to unmask antigens in paraffin-embedded tissue helped to demonstrate that the tumor expressed Yo antigens. A 68-year-old right-handed man with a medical history of heavy tobacco and alcohol use presented to the neurology clinic with a 2-month history of progressively unsteady gait and frequent falls. He denied heavy alcohol use over this period. On physical examination he had gynecomastia and normal male genitalia except for an undescended testis. There was severe bilateral dysmetria involving only the legs, without weakness or sensory loss. A repeat examination 1 month later demonstrated progression of symptoms. It also showed dysarthria with Scanning Speech, multidirectional gaze-evoked nystagmus, …
