Abstract
The authors report a 71-year-old woman with amphiphysin-associated paraneoplastic stiff-person syndrome, opsoclonus, and encephalopathy. The patient's symptoms temporarily responded to plasmapheresis in parallel with a decline of serum anti-amphiphysin antibody titers. Later, the encephalopathy progressed rapidly and the patient died. Binding studies and the detection of autoantibodies in the patient's CNS as well as the treatment response suggest a pathogenic role of the anti-amphiphysin antibodies.
MeSH terms
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Aged
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Animals
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Antigen-Antibody Reactions
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Autoantibodies / blood
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Autoantibodies / immunology*
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Autoantigens / immunology*
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Autoimmune Diseases of the Nervous System / etiology
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Autoimmune Diseases of the Nervous System / immunology*
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Autoimmune Diseases of the Nervous System / pathology
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Autoimmune Diseases of the Nervous System / therapy
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Breast Neoplasms / complications
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Breast Neoplasms / immunology
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Carcinoma, Ductal, Breast / complications
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Carcinoma, Ductal, Breast / immunology
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Cognition Disorders / drug therapy
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Cognition Disorders / etiology
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Cognition Disorders / immunology
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Cognition Disorders / pathology
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Combined Modality Therapy
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Cyclophosphamide / therapeutic use
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Disease Progression
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Fatal Outcome
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Female
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Gliosis / etiology
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Gliosis / pathology
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Humans
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Immunosuppressive Agents / therapeutic use
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Magnetic Resonance Imaging
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Nerve Tissue Proteins / immunology*
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Ocular Motility Disorders / drug therapy
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Ocular Motility Disorders / etiology
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Ocular Motility Disorders / immunology
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Ocular Motility Disorders / pathology
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Paraneoplastic Syndromes / etiology
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Paraneoplastic Syndromes / immunology*
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Paraneoplastic Syndromes / pathology
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Paraneoplastic Syndromes / therapy
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Plasmapheresis
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Pons / pathology*
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Rats
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Spinal Cord / pathology*
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Stiff-Person Syndrome / etiology
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Stiff-Person Syndrome / immunology*
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Stiff-Person Syndrome / pathology
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Stiff-Person Syndrome / therapy
Substances
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Autoantibodies
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Autoantigens
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Immunosuppressive Agents
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Nerve Tissue Proteins
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amphiphysin
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Cyclophosphamide