Child's Nervous System

, Volume 33, Issue 3, pp 509–512 | Cite as

Hodgkin’s lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature

  • Serdal Gungor
  • Betul Kilic
  • Mujgan Arslan
  • Unsal Ozgen
  • Josep Dalmau
Case Report
  • 286 Downloads

Abstract

Paraneoplastic cerebellar degeneration (PCD) can occur severely and appear as subacute cerebellar syndrome. PCD may be associated with small cell lung cancer, adenocarcinoma, breast cancer, ovarian carcinoma, and Hodgkin’s lymphoma. An 11-year-old male was admitted with acute cerebellar ataxia, dysarthria, and diplopia. Mediastinal conglomerated lymph nodes were depicted in a chest computed tomography (CT) examination, and diagnosis of stage IV Hodgkin’s lymphoma was obtained after a lymph node biopsy. The antibodies against Purkinje cells (anti-Tr antibody) were positive immunohistochemically. Thus, paraneoplastic cerebellar degeneration depending on Hodgkin’s disease was diagnosed. Despite the completion of chemotherapy, neurological recovery was not observed in the patient and plasmapheresis with immunoadsorption, and intravenous immunoglobulin (IVIG) was performed. Truncal ataxia, gait disturbance, and tremors decreased. Consequently, we thought that plasmapheresis with the immunoadsorption method and IVIG therapy might be a treatment option for cerebellar ataxia caused by a mechanism of immune ancestry.

Keywords

Anti-Tr antibodies Immunoadsorption Hodgkin’s disease Paraneoplastic cerebellar degeneration 

Notes

Acknowledgments

None

Compliance with ethical standards

Conflict of interest

Authors declare they have no conflict of interest.

Funding

None

Supplementary material

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References

  1. 1.
    Graus F, Arino H, Dalmau J (2014) Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas. Blood 123:3230–3238CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Darnell RB, Posner JB (2011) Paraneoplastic syndromes. Contemporary neurology series. Oxford University Press 79:1–482Google Scholar
  3. 3.
    Shams’ili S, Grefkens J, de Leeuw B, van den Bent M, Hooijkaas H, van der Holt B et al (2003) Paraneoplastic cerebellar degeneration associated with antineuronal antibodies: analysis of 50 patients. Brain 126:1409–1418CrossRefPubMedGoogle Scholar
  4. 4.
    Dalmau J, Rosenfeld MR (2008) Paraneoplastic syndromes of the CNS. Lancet Neurol 7:327–340CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Bernal F, Shams’ili S, Rojas I, Sanchez-Valle R, Saiz A, Dalmau J et al (2003) Anti-Tr antibodies as markers of paraneoplastic cerebellar degeneration and Hodgkin’s disease. Neurology 60:230–234CrossRefPubMedGoogle Scholar
  6. 6.
    Posner JB (1995) Paraneoplastic syndromes. In: Posner JB (ed) Neurologic complications of cancer. F.A. Davis, Philadelphia, pp. 353–385Google Scholar
  7. 7.
    Rewcastle NB (1963) Subacute cerebellar degeneration with Hodgkin’s disease. Arch Neurol 9:407–413CrossRefPubMedGoogle Scholar
  8. 8.
    Trotter JL, Hendin BA, Osterland CK (1976) Cerebellar degeneration with Hodgkin’s disease. An immunological study. Arch Neurol 33:660–661CrossRefPubMedGoogle Scholar
  9. 9.
    Graus F, Dalmau J (2007) Paraneoplastic neurological syndromes: diagnosis and treatment. Curr Opin Neurol 20:732–737PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Serdal Gungor
    • 1
  • Betul Kilic
    • 1
  • Mujgan Arslan
    • 1
  • Unsal Ozgen
    • 2
  • Josep Dalmau
    • 3
  1. 1.Faculty of Medicine, Department of Pediatric NeurologyInonu UniversityMalatyaTurkey
  2. 2.Faculty of Medicine, Department of Pediatric HematologyInonu UniversityMalatyaTurkey
  3. 3.University of Barcelona, Catalan Institution of Research and Advanced Studies (ICREA) and Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital ClinicBarcelonaSpain

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