Immune-mediated Neuropathy with Anti-disialosyl IgM Antibodies in Diffuse Large B-cell Lymphoma: A Case Report and Literature Review

Gen Shihashi; Takuya Yagi; Shigeaki Suzuki; Morinobu Seki; Sumiko Kohashi; Tomoki Ueda; Kaori Kameyama; Susumu Kusunoki; Hideaki Nakajima; Shinichiro Okamoto; Norihiro Suzuki

doi:10.2169/internalmedicine.54.4451

CASE REPORTS

Immune-mediated Neuropathy with Anti-disialosyl IgM Antibodies in Diffuse Large B-cell Lymphoma: A Case Report and Literature Review

Gen Shihashi, Takuya Yagi, Shigeaki Suzuki, Morinobu Seki, Sumiko Kohashi, Tomoki Ueda, Kaori Kameyama, Susumu Kusunoki, Hideaki Nakajima, Shinichiro Okamoto, Norihiro Suzuki

Author information

Gen Shihashi
Department of Neurology, Keio University School of Medicine, Japan
Takuya Yagi
Department of Neurology, Keio University School of Medicine, Japan
Shigeaki Suzuki
Department of Neurology, Keio University School of Medicine, Japan
Morinobu Seki
Department of Neurology, Keio University School of Medicine, Japan
Sumiko Kohashi
Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
Tomoki Ueda
Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
Kaori Kameyama
Department of Pathology, Keio University School of Medicine, Japan
Susumu Kusunoki
Department of Neurology, Kinki University School of Medicine, Japan
Hideaki Nakajima
Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
Shinichiro Okamoto
Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
Norihiro Suzuki
Department of Neurology, Keio University School of Medicine, Japan

Keywords: Guillain-Barré syndrome, malignant lymphoma, immune-mediated neuropathy, anti-ganglioside antibody, paraneoplastic syndrome, diffuse large B-cell lymphoma

JOURNAL OPEN ACCESS

2015 Volume 54 Issue 13 Pages 1647-1651

DOI https://doi.org/10.2169/internalmedicine.54.4451

Details

Abstract

A 36-year-old man with diffuse large B-cell lymphoma presented with polyneuropathy, and the diagnostic work-up revealed the presence of IgM antibodies against gangliosides with disialosyl residues (GD1b, GD3). He was treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone and received high-dose intravenous immunoglobulin for the treatment of neuropathy. After initiating the treatments, the patient's neurological impairment improved dramatically. He currently remains in complete remission without a flare-up of the polyneuropathy. Based upon our experience and other case reports of lymphoma with immune-mediated neuropathy caused by anti-disialosyl ganglioside IgM antibodies, we conclude that determining the anti-ganglioside antibody profile and beginning early treatment should be considered promptly for patients with malignant lymphoma who develop polyneuropathy.

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