[A case of paraneoplastic myelopathy associated with anti-CV2/CRMP5 antibodies with small-cell lung cancer]

Rinsho Shinkeigaku. 2020 Aug 7;60(8):560-564. doi: 10.5692/clinicalneurol.60.cn-001432. Epub 2020 Jul 7.
[Article in Japanese]

Abstract

A 66-year-old woman with small-cell lung cancer and cancer-associated retinopathy with anti-recoverin antibodies presented with subacute paraplegia associated with recurrence of lung cancer. Although a spinal cord MRI did not show any visible lesion, the neurological symptoms and cerebrospinal fluid findings indicated myelitis. Anti-CV2/CRMP5 antibodies were also positive and the patient was diagnosed with paraneoplastic myelopathy. After medication with prednisolone, her neurological symptoms improved and she survived over three years without recurrence of neurological symptoms. In general, paraneoplastic myelopathy is refractory against immunotherapy but in this case, immunotherapy was successful and resulted in long-term survival. We recommend examining anti-neuronal antibodies and choose and continue the appropriate immunotherapy.

Keywords: anti CV2/CRMP5 antibody; cancer associated retinopathy with anti-Recoverin antibody; myelopathy; paraneoplastic neurological syndrome.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies*
  • Female
  • Humans
  • Hydrolases / immunology*
  • Immunotherapy
  • Lung Neoplasms / immunology*
  • Lung Neoplasms / therapy
  • Microtubule-Associated Proteins / immunology*
  • Neoplasm Recurrence, Local
  • Paraneoplastic Syndromes, Nervous System / etiology
  • Paraneoplastic Syndromes, Nervous System / immunology*
  • Paraneoplastic Syndromes, Nervous System / therapy
  • Small Cell Lung Carcinoma / immunology*
  • Small Cell Lung Carcinoma / therapy

Substances

  • Autoantibodies
  • Microtubule-Associated Proteins
  • DPYSL5 protein, human
  • Hydrolases