Journal
BMC PSYCHIATRY
Volume 15, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12888-015-0486-x
Keywords
Anti-Yo reactivity; Low titre; Cerebellum; Atrophy; Paraneoplastic neurological syndrome
Categories
Funding
- Bayer Vital GmbH
- Biogen Idec
- Genzyme
- Merck Serono
- Novartis
- Sanofi-Aventis
- Teva
- GE
- Eli Lilly
- Janssen-Cilag
- Shire
- UCB
- GSK
- Servier
- Janssen
- Cyberonics
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Background: Autoimmune and inflammatory mechanisms in psychotic disorders have attracted increasing scientific attention in recent years. In this regard, we performed routine cerebrospinal fluid (CSF) basic diagnostics and CSF/serum analyses for antibodies directed against neuronal intracellular and surface antigens in psychotic patients. In this context, the patient presented in this paper was diagnosed. Case presentation: We present the case of a 20-year-old female patient with a first episode of a drug-induced psychotic syndrome but without neurological deficits. Further investigations showed a reproducible low-titre positive anti-Yo reactivity in the CSF and serum with two independent immunoblot assays. Magnetic resonance imaging showed frontoparietal and cerebellar atrophy. On [F-18] fluorodeoxyglucose positron emission tomography, a mild cerebellar hypometabolism was found. No underlying tumor was detected. Conclusion: Despite the presence of anti-Yo reactivity, the diagnostic criteria for a paraneoplastic neurological syndrome were not fulfilled. Previously published data indicate the possible association between low-titer antibodies against intracellular localized, onconeural antigens, and psychotic disorders. Large prospective studies that investigate the prevalence and clinical significance of antibodies against intracellular onconeural antigens in psychiatry are needed.
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