Sepsis-Induced Anti-Amphiphysin Antibody-Associated Paraneoplastic Syndrome: A Case Report

Sepsis is a severe systemic response to infection that can induce a variety of complications, including paraneoplastic syndrome (PNS). Anti-amphiphysin antibody-associated PNS is a rare autoimmune disorder associated with tumors. We review the case of a 27-year-old man who presented with a 3-day history of fever, disturbance of consciousness, and oliguria. After 3 weeks of intensive care unit admissions, the muscle strength of his limbs gradually decreased to grade 0. The cerebrospinal fluid (CSF) specimen revealed elevated protein, and electromyography showed peripheral nerve damage. The blood test for anti-amphiphysin antibody titer resulted positive (1:30, RI < 1:30). Sepsis, diabetic ketoacidosis, and multiple organ dysfunction syndrome (MODS) were followed by anti-amphiphysin antibody-associated PNS. He was treated with methylprednisolone and immunoglobulin. Rehabilitation therapy was initiated after discharge. One year of follow-up indicated muscle strength at grade 4 with normal muscle tone, and chest CT did not reveal any pulmonary tumors. Anti-amphiphysin antibodies are usually associated with neurologic diseases and are rarely related to sepsis. We aim to raise awareness of sepsis-induced anti-amphiphysin antibody-associated paraneoplastic syndrome, which has a poor prognosis and a high case fatality rate. Early recognition and treatment are essential to improve the prognosis.