Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4190-4195
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4190
Paraneoplastic neurological syndrome with positive anti-Hu and anti-Yo antibodies: A case report
Zi-Chao Li, Hong-Bin Cai, Zhen-Zhen Fan, Xiao-Bin Zhai, Zhao-Ming Ge
Zi-Chao Li, Hong-Bin Cai, Zhen-Zhen Fan, Xiao-Bin Zhai, Zhao-Ming Ge, Department of Neurology, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province, China
Author contributions: Li ZC were the patient’s neurologist, reviewed the literature and contributed to manuscript drafting; Cai HB analyzed and interpreted the imaging findings; Fan ZZ and Zhai XB were responsible for the revision of the manuscript for important intellectual content; and all authors issued final approval for the version to be submitted; the manuscript was supported by Ge ZM.
Supported by Natural Science Foundation of Gansu Province, No. 20JR10RA719.
Informed consent statement: Written informed consent for the publication of the clinical details and the radiological images was obtained from the patient.
Conflict-of-interest statement: There are no conflicts of interest related to this report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhao-Ming Ge, MD, Chief Doctor, Department of Neurology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu Province, China. gezhaoming123456@163.com
Received: September 8, 2021
Peer-review started: September 8, 2021
First decision: October 27, 2021
Revised: November 5, 2021
Accepted: March 14, 2022
Article in press: March 14, 2022
Published online: May 6, 2022
Processing time: 234 Days and 2.2 Hours
Abstract
BACKGROUND

Paraneoplastic neurological syndrome (PNS) is a rare complication in patients with cancer. PNS can affect the central, peripheral, autonomic nervous system, neuromuscular junction, or muscles and cause various neurological symptoms. Anti-Yo antibody-positive neurological paraneoplasms and anti-Hu antibody-positive neurological paraneoplasms are common, but coexistence of both types has not been described in the literature.

CASE SUMMARY

Here we present a rare case of paraneoplastic neuropathy occurring in both breast and lung cancers. A 55-year-old woman was admitted to our hospital with unsteadiness while walking. The patient had a history of breast cancer two years previously. Chest computed tomography revealed a 4.6 cm × 3.6 cm mass in the right lung, which was diagnosed as small-cell lung cancer (SCLC). Blood test was positive for anti-Yo antibodies, and the cerebrospinal fluid was positive for both anti-Yo and anti-Hu antibodies, and the neurological symptoms were considered to be related to the paraneoplasm. The patient was treated with a course of intravenous immunoglobulin, without noticeable improvement. After being discharged from hospital, the patient underwent regular chemotherapy for SCLC and periodic reviews. The patient’s neurological symptoms continued to deteriorate at the follow-up visit in April 2021.

CONCLUSION

This case suggests the possibility of two types of tumors appearing simultaneously with two paraneoplastic antibodies. The clinical appearance of two or more paraneoplastic tumors requires additional attention.

Keywords: Paraneoplastic syndrome; Anti-Hu antibody; Anti-Yo antibody; Small cell lung cancer; Breast cancer; Intravenous immunoglobulin; Case report

Core Tip: Neurological paraneoplastic syndrome is a common manifestation in patients with tumors, and in some cases, it appears earlier than the tumor. We report a rare case in which two different paraneoplastic antibodies were present. While most previous studies have reported this syndrome due to one tumor, this patient presented with two different tumors and two paraneoplastic antibodies at the same time, causing neurological symptoms such as ataxia, limb numbness, and weakness. This case highlights the specificity of paraneoplastic antibodies to their corresponding tumors, avoiding a missed diagnosis when multiple antibodies are present and providing a reference for future clinical diagnosis.