Paraneoplastic ophthalmoplegia and subacute motor axonal neuropathy associated with anti-GQ1b antibodies in a patient with malignant melanoma
- 1Department of Neurology, Erasmus University Medical Centre, Rotterdam, Netherlands
- 2Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre
- 3Department of Medical Oncology, Erasmus University Medical Centre
- Correspondence to: Dr Peter Sillevis Smitt, Department of Neurology, Erasmus University Medical Centre, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands; sillevis{at}neuh.azr.nl
- Received 20 October 2002
- Accepted 2 December 2002
Abstract
A 68 year old woman developed oculomotor paresis shortly after metastatic progression of her melanoma was discovered. She was then immunised with the tumour antigen MAGE-3 in combination with an immunological adjuvant. During immunisation her symptoms worsened and she developed severe, predominantly proximal axonal motor neuropathy and became bedridden. IgM antibodies against gangliosides GM2, GD3, and GQ1b were detected in serum obtained two weeks before and nine weeks after the onset of symptoms. Immunohistochemically, the patient’s IgM reacted with the tumour and co-localised with GQ1b. She improved neurologically following steroid treatment and became ambulatory.
Footnotes
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L Kloos is presently at the Neurology Department, Leyenburg Ziekenhuis, Den Haag, The Netherlands
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Competing interests: none declared
