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Anti-CV2/CRMP5 antibody-associated hemorrhagic leukoencephalomyelitis treated with steroids, intravenous immunoglobulin, plasmapheresis, and cyclophosphamide.
Mult Scler Relat Disord. 2020 May; 40:101964.MS

Abstract

Anti-CV2 or anti-collapsing response-mediator protein-5 (CRMP5) autoantibodies (anti-CV2/CRMP5-Ab) are associated with various paraneoplastic neurological disorders. The best therapy is typically removal of the underlying cancer. We describe a previously healthy elderly male who had no known malignancy. He presented with a demyelinating encephalomyelitis and later developed hemorrhagic changes on neuroimaging. He was treated with intravenous immunoglobulin (IVIG), intravenous steroids, and plasmapheresis; however, sustained clinical and radiographic stabilization and improvement only occurred following cyclophosphamide. He unexpectedly died of a cardiac arrest. postmortem, his serum paraneoplastic screen was found to be weakly positive for anti-CV2/CRMP5-Ab.

Authors+Show Affiliations

Department of Neurology, Memorial University of Newfoundland, Newfoundland and Labrador, 300 Prince Phillip Drive, St. John's A1B 3V6, Canada. Electronic address: laura.chu@medportal.ca.Department of Neurology, Memorial University of Newfoundland, Newfoundland and Labrador, 300 Prince Phillip Drive, St. John's A1B 3V6, Canada.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32044694

Citation

Chu, Laura, and Fraser Clift. "Anti-CV2/CRMP5 Antibody-associated Hemorrhagic Leukoencephalomyelitis Treated With Steroids, Intravenous Immunoglobulin, Plasmapheresis, and Cyclophosphamide." Multiple Sclerosis and Related Disorders, vol. 40, 2020, p. 101964.
Chu L, Clift F. Anti-CV2/CRMP5 antibody-associated hemorrhagic leukoencephalomyelitis treated with steroids, intravenous immunoglobulin, plasmapheresis, and cyclophosphamide. Mult Scler Relat Disord. 2020;40:101964.
Chu, L., & Clift, F. (2020). Anti-CV2/CRMP5 antibody-associated hemorrhagic leukoencephalomyelitis treated with steroids, intravenous immunoglobulin, plasmapheresis, and cyclophosphamide. Multiple Sclerosis and Related Disorders, 40, 101964. https://doi.org/10.1016/j.msard.2020.101964
Chu L, Clift F. Anti-CV2/CRMP5 Antibody-associated Hemorrhagic Leukoencephalomyelitis Treated With Steroids, Intravenous Immunoglobulin, Plasmapheresis, and Cyclophosphamide. Mult Scler Relat Disord. 2020;40:101964. PubMed PMID: 32044694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anti-CV2/CRMP5 antibody-associated hemorrhagic leukoencephalomyelitis treated with steroids, intravenous immunoglobulin, plasmapheresis, and cyclophosphamide. AU - Chu,Laura, AU - Clift,Fraser, Y1 - 2020/01/22/ PY - 2019/10/05/received PY - 2020/01/18/revised PY - 2020/01/21/accepted PY - 2020/2/12/pubmed PY - 2020/2/12/medline PY - 2020/2/12/entrez KW - Anti-CV2/CRMP5 antibodies KW - Autoimmune KW - Cyclophosphamide KW - Demyelination KW - Hemorrhagic leukoencephalomyelitis KW - Immunotherapy KW - Paraneoplastic SP - 101964 EP - 101964 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 40 N2 - Anti-CV2 or anti-collapsing response-mediator protein-5 (CRMP5) autoantibodies (anti-CV2/CRMP5-Ab) are associated with various paraneoplastic neurological disorders. The best therapy is typically removal of the underlying cancer. We describe a previously healthy elderly male who had no known malignancy. He presented with a demyelinating encephalomyelitis and later developed hemorrhagic changes on neuroimaging. He was treated with intravenous immunoglobulin (IVIG), intravenous steroids, and plasmapheresis; however, sustained clinical and radiographic stabilization and improvement only occurred following cyclophosphamide. He unexpectedly died of a cardiac arrest. postmortem, his serum paraneoplastic screen was found to be weakly positive for anti-CV2/CRMP5-Ab. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/32044694/Anti_CV2/CRMP5_antibody_associated_hemorrhagic_leukoencephalomyelitis_treated_with_steroids_intravenous_immunoglobulin_plasmapheresis_and_cyclophosphamide_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(20)30040-7 DB - PRIME DP - Unbound Medicine ER -
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