Tenascin-R Autoimmunity: Isolated Tremor Reversed with Immunotherapy

Binxia Yang; Andrew Brown; Andrew McKeon; J. Eric Ahlskog; Philip Tipton; Yong Guo; Claudia Lucchinetti; Sean J. Pittock; Anastasia Zekeridou

doi:10.1002/ana.26730

Tenascin-R Autoimmunity: Isolated Tremor Reversed with Immunotherapy

Binxia Yang, Andrew Brown, Andrew McKeon, J. Eric Ahlskog, Philip Tipton, Yong Guo, Claudia Lucchinetti, Sean J. Pittock, Anastasia Zekeridou

Research output: Contribution to journal › Article › peer-review

Abstract

Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and harbored a neural tissue-restricted antibody. The autoantigen was identified by immunoprecipitation and mass spectrometry and confirmed by antigen-specific assays to be specific for tenascin-R. He was investigated for cancer and diagnosed with follicular lymphoma that expressed tenascin-R suggesting a paraneoplastic origin; cancer treatment and immunotherapy led to complete recovery. With this individualized patient approach and antibody discovery, we expand the spectrum of antibodies accompanying autoimmune hyperkinetic movement disorders. ANN NEUROL 2023;94:502–507.

Original language	English (US)
Pages (from-to)	502-507
Number of pages	6
Journal	Annals of neurology
Volume	94
Issue number	3
DOIs	https://doi.org/10.1002/ana.26730
State	Published - Sep 2023

ASJC Scopus subject areas

Neurology
Clinical Neurology

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title = "Tenascin-R Autoimmunity: Isolated Tremor Reversed with Immunotherapy",

abstract = "Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and harbored a neural tissue-restricted antibody. The autoantigen was identified by immunoprecipitation and mass spectrometry and confirmed by antigen-specific assays to be specific for tenascin-R. He was investigated for cancer and diagnosed with follicular lymphoma that expressed tenascin-R suggesting a paraneoplastic origin; cancer treatment and immunotherapy led to complete recovery. With this individualized patient approach and antibody discovery, we expand the spectrum of antibodies accompanying autoimmune hyperkinetic movement disorders. ANN NEUROL 2023;94:502–507.",

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AU - Yang, Binxia

AU - Brown, Andrew

AU - McKeon, Andrew

AU - Ahlskog, J. Eric

AU - Tipton, Philip

AU - Guo, Yong

AU - Lucchinetti, Claudia

AU - Pittock, Sean J.

AU - Zekeridou, Anastasia

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AB - Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and harbored a neural tissue-restricted antibody. The autoantigen was identified by immunoprecipitation and mass spectrometry and confirmed by antigen-specific assays to be specific for tenascin-R. He was investigated for cancer and diagnosed with follicular lymphoma that expressed tenascin-R suggesting a paraneoplastic origin; cancer treatment and immunotherapy led to complete recovery. With this individualized patient approach and antibody discovery, we expand the spectrum of antibodies accompanying autoimmune hyperkinetic movement disorders. ANN NEUROL 2023;94:502–507.

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Tenascin-R Autoimmunity: Isolated Tremor Reversed with Immunotherapy

Abstract

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