Sánchez-Roy R, Pareja-Martínez A, Valero C, Perla C, Villarroya T, Bonet M, Graus F
Sevicio de Neurología Interna, Sección de Neurología, Hospital Arnau de Vilanova, Valencia.
Neurologia. 2004 Oct;19(8):456-9.
The presence of antineuronal anti-Tr antibodies is associated to paraneoplastic cerebellar degeneration due to Hodgkin's disease. The anti-Tr can become negative after successful and early treatment of the tumor, and there could even be remission of the cerebellar symptoms in some patients. There are few cases in which no tumor is found when there are anti-Tr. We report the case of a 66 year old man with a severe cerebellar syndrome and anti-Tr in serum detected by immunohistochemistry. After a 4 year follow-up, no underlying tumor has been found. In addition, anti-Tr spontaneously disappeared. The cerebellar degeneration persists and is incapacitating. This case suggests that in a few instances the origin of anti-Tr is not a tumor but another unknown cause. Alternatively the anti-Tr mediated immune response could have eradicated the underlying lymphoma.
抗神经元抗Tr抗体的存在与霍奇金病所致副肿瘤性小脑变性相关。在肿瘤得到成功早期治疗后,抗Tr抗体可能转为阴性,甚至部分患者的小脑症状会有所缓解。存在抗Tr抗体但未发现肿瘤的病例较少。我们报告一例66岁男性,患有严重小脑综合征,免疫组化检测血清中存在抗Tr抗体。经过4年随访,未发现潜在肿瘤。此外,抗Tr抗体自行消失。小脑变性持续存在且导致功能丧失。该病例提示,在少数情况下,抗Tr抗体的来源并非肿瘤而是其他未知原因。或者,抗Tr介导的免疫反应可能已根除了潜在的淋巴瘤。