Rinsho Shinkeigaku (Clinical Neurology)

Case Report

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

Chika Sato, M.D.1), Takahiro Kano, M.D., Ph.D.2), Ichiro Yabe, M.D., Ph.D.1) and Hidenao Sasaki, M.D., Ph.D.1)3)

1) Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
2) Obihiro Kosei Hospital, Department of Neurology
3) Hakodate Central General Hospital, Department of Neurology

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.
Full Text of this Article in Japanese PDF (2936K)

(CLINICA NEUROL, 60: 560|564, 2020)
key words: paraneoplastic neurological syndrome, myelopathy, anti CV2/CRMP5 antibody, cancer associated retinopathy with anti-Recoverin antibody

(Received: 12-Feb-20)