PARANEOPLASTIC CEREBELLAR DEGENERATION WITH A CIRCULATING ANTIBODY AGAINST NEURONS AND NONNEURONAL CELLS

We describe a woman with paraneoplastic cerebellar degeneration associ ated with para-ovarian adenocarcinoma, who had a circulating antibody with a corresponding antigen not only in cerebellar Purkinje cells but also in neurons located in the molecular layer of the human and rat c erebellum. The antigen was also present in neurons in the cerebral cor tex, brain stem, anterior horn cells, dorsal root ganglia, intestinal autonomic neurons, retinal ganglion cells, Schwann cells of the periph eral nerve and epithelial cells of the renal glomerulus in rats. Immun oelectron microscopy revealed immunoprecipitates in the smooth and rou gh endoplasmic reticulum and polyribosomes in human and rat cerebellar Purkinje cells and other neuronal cell bodies as well as Schwann cell s of the peripheral nerve. Even though patients with this disorder man ifest primarily with cerebellar and some extracerebellar signs, the an tigen also exists in many neurons other than cerebellar Purkinje cells and even in non-neuronal cells. The clinicopathologic significance of the observed immunologic reaction in diverse neurons remains to be de termined.