J Neurocrit Care.  2020 Dec;13(2):105-108. 10.18700/jnc.200013.

Anti-Yo-associated autoimmune encephalitis after colon cancer treatment

• Jung NY
• Woo KN
• Cho JW
• Kim HW

• KMID: 2509940
• DOI: http://doi.org/10.18700/jnc.200013

Abstract

Background
Anti-Yo antibodies are classically associated with paraneoplastic cerebellar degeneration in ovarian and breast cancers and are rarely seen in colon cancer. Anti-Yo-associated paraneoplastic autoimmune encephalitis in colon cancer is rare.
Case Report
A 66-year-old man presented with new-onset seizures after completion of a scheduled treatment for colon cancer. Magnetic resonance imaging showed hyperintense signals with enhancement in the left temporal lobe and insular cortex. Cerebrospinal fluid findings included pleocytosis and elevated protein levels, while Yo antibodies were detected in the serum. There was no relapse of colon cancer, nor were any new cancers found. The patient’s symptoms and laboratory test results improved after the administration of high-dose steroids, intravenous immunoglobulin, and plasmapheresis with antiepileptic drugs.
Conclusion
This is a rare case of autoimmune encephalitis with anti-Yo antibodies. The appearance of new-onset seizures during the treatment of malignancy should raise suspicions for paraneoplastic autoimmune encephalitis, even after surgery and chemotherapy are completed.

Keyword

Anti-Yo antibody; Autoimmune encephalitis; Colon adenocarcinoma; Seizure

Figure

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  Fig. 1. Fluid-attenuated inversion recovery (FLAIR; left) and contrast-enhanced (right) magnetic resonance imaging taken on the day of onset of the seizure (A), day 28 (B), and day 53 (C). Enhancement in the left temporal lobe and insular cortex (arrows in B) decreased in images of day 53 (C). The last follow-up FLAIR images showed hyperintense signals in the left temporal lobe, subcallosal gyrus, and insular cortex (arrowheads).

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