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Immunological and clinical response to immunosuppressive treatment in paraneoplastic cerebellar degeneration
Objective:
To report the clinical and immunological response to immunosuppressive treatment with cyclophosphamide in two patients with paraneoplastic cerebellar degeneration.
Design:
Case reports. Clinical and immunological follow-up data available for 4 1/2 years in the first patient and for 2 years in the second patient.
Setting:
A 1500-bed university hospital and a 1200-bed university teaching hospital.
Intervention:
Cyclophosphamide intermittent treatment.
Main Outcome Measure:
Clinical disability.
Results:
One of the patients, who was treated from an early stage, recovered completely. The other patient showed a partial clinical response. While the two patients were receiving a maintenance regimen with cyclophosphamide, the conditions of both patients remained stable for at least 2 years. In both patients, intrathecal antibody synthesis declined considerably.
Conclusion:
Early induction of immunosuppressive therapy with cyclophosphamide should be tried in treating patients with paraneoplastic cerebellar degeneration.
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