David Y B, Warner E, Levitan M, Sutton D M, Malkin M G, Dalmau J O
Department of Obstetrics and Gynecology, Haddash Hospital, Mount Scopus, Jerusalem, Israel.
Cancer. 1996 Nov 15;78(10):2153-6.
Paraneoplastic cerebellar degeneration (PCD) is a remote effect of cancer most frequently associated with carcinoma of the ovary or lung. In many patients, antibodies to Purkinje cells are found. Progressive, incapacitating cerebellar dysfunction occurs in most cases, and no treatment has produced even a transient response in any significant proportion of patients.
A woman age 81 years with recurrent ovarian carcinoma and PCD, confirmed clinically, radiologically, and serologically, was treated with 5 exchanges of 1 plasma volume each, followed by intravenous immunoglobulin at a dose of 1g/Kg-1 body weight daily for 2 days.
Several weeks after the treatment, the patient had significant improvement of her dizziness, tremor, and dysmetria. She refused maintenance therapy and began to deteriorate neurologically 3 months after the treatment.
Although this is only a single case report, the authors believe that the dire prognosis of PCD and the lack of effective therapy warrant a trial of this combined treatment early in the course of the disease. Confirmatory evidence of the efficacy of such an approach would be welcomed.
副肿瘤性小脑变性（PCD）是癌症的一种远隔效应，最常与卵巢癌或肺癌相关。在许多患者中，可发现抗浦肯野细胞抗体。大多数病例会出现进行性、致残性小脑功能障碍，而且在任何相当比例的患者中，尚无治疗能产生哪怕是短暂的反应。
一名81岁患有复发性卵巢癌和PCD的女性，经临床、放射学和血清学确诊，接受了5次每次置换1个血浆容量的治疗，随后静脉注射免疫球蛋白，剂量为每日1g/kg体重，共2天。
治疗数周后，患者的头晕、震颤和辨距不良有显著改善。她拒绝维持治疗，治疗3个月后神经功能开始恶化。
尽管这只是一篇个案报告，但作者认为PCD的可怕预后以及缺乏有效治疗方法，使得在疾病早期试用这种联合治疗是合理的。欢迎提供这种方法有效性的确证证据。
