Immunological and Clinical Response to Immunosuppressive Treatment in Paraneoplastic Cerebellar Degeneration
Erwin Stark, MD;
Ulrich Wurster, PhD;
Udo Patzold, MD;
Michael Sailer, MD;
Judith Haas, MD
Arch Neurol. 1995;52(8):814-818.
Abstract
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Objective
To report the clinical and immunological response to immunosuppressive treatment with cyclophosphamide in two patients with paraneoplastic cerebellar degeneration.
Design
Case reports. Clinical and immunological follow-up data were available for 4 years in the first patient and for 2 years in the second patient.
Setting
A 1500-bed university hospital and a 1200-bed university teaching hospital.
Intervention
Cyclophosphamide intermittent treatment.
Main Outcome Measure
Clinical disability.
Results
One of the patients, who was treated from an early stage, recovered completely. The other patient showed a partial clinical response. While the two patients were receiving a maintenance regimen with cyclophosphamide, the conditions of both patients remained stable for at least 2 years. In both patients, intrathecal antibody synthesis declined considerably.
Conclusion
Early induction of immunosuppressive therapy with cyclophosphamide should be tried in treating patients with paraneoplastic cerebellar degeneration.
Author Affiliations
From the Department of Neurology, Hannover (Germany) Medical School (Drs Stark, Wurster, Sailer, and Haas), and the Neurological Clinic, Municipal Hospital, Braunschweig, Germany (Dr Patzold). Dr Stark is now affiliated with Städtische Kliniken Offenbach (Germany).
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