Antineuronal autoantibodies in paraneoplastic cerebellar degeneration associated with adenocarcinoma of the prostate

Greenlee, John E.; Clawson, Susan A.; Hill, Kenneth E.; Dechet, Christopher B.; Carlson, Noel G.

doi:10.1016/j.jns.2009.12.019

« Previous Next »Journal of the Neurological Sciences
Volume 291, Issue 1 , Pages 74-78, 15 April 2010

Antineuronal autoantibodies in paraneoplastic cerebellar degeneration associated with adenocarcinoma of the prostate

John E. Greenlee
- Neurology Service, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Brain Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Corresponding author. Neurology Service (127) Veterans Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA. Tel.: +1 801 584 1218; fax: +1 801 582 6908.
Susan A. Clawson
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
Kenneth E. Hill
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
Christopher B. Dechet
- Division of Urology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
Noel G. Carlson
- GRECC, George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA
- Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Neurobiology and Anatomy, University of Utah School of Medicine, Salt Lake City, UT, USA
- Brain Institute, University of Utah School of Medicine, Salt Lake City, UT, USA

Received 3 October 2009; received in revised form 11 December 2009; accepted 18 December 2009. published online 20 January 2010.

Abstract

Paraneoplastic neurological syndromes are unusual in prostatic cancer, and paraneoplastic cerebellar degeneration associated with adenocarcinoma of the prostate is rare. Here we report a 68year old man who developed progressive ataxia in the setting of stage D2 adenocarcinoma of the prostate and whose MRI showed cerebellar atrophy. The patient's serum produced a previously undescribed pattern of immunoreactivity, binding to nuclei and cytoplasm of Purkinje cells, deep cerebellar neurons, scattered cells in the molecular and granule cell layers, and neuronal populations in thalamus, cerebral cortex, and hippocampus but not with liver or kidney. The patient's IgG also labeled a 65kDa protein, discrete from Yo antigen, in Western blots of Purkinje cell lysates and did not react with blotted recombinant HuD, Ri, Yo, or amphiphysin proteins. Sera from neurologically normal patients with adenocarcinoma of the prostate did not contain this antibody, and the patient's serum did not react with normal prostate or with prostatic adenocarcinomas from other individuals. Prostatic adenocarcinoma may occasionally be accompanied by development of anticerebellar antibodies. Adenocarcinoma of the prostate should be considered as a possible underlying malignancy in older males with unexplained progressive cerebellar degeneration.