Asymmetrical and Isolated Hypoglossal Nerve Palsy Accompanied by a New Subset of Anti-ganglioside Antibodies in a Patient with Diffuse Large B Cell Lymphoma

Yasuyuki Ohta; Yuko Kawahara; Koh Tadokoro; Kota Sato; Ryo Sasaki; Yoshiaki Takahashi; Mami Takemoto; Nozomi Hishikawa; Toru Yamashita; Takeru Asano; Tomoko Inomata; Koji Abe

doi:10.2169/internalmedicine.1269-18

CASE REPORTS

Asymmetrical and Isolated Hypoglossal Nerve Palsy Accompanied by a New Subset of Anti-ganglioside Antibodies in a Patient with Diffuse Large B Cell Lymphoma

Yasuyuki Ohta, Yuko Kawahara, Koh Tadokoro, Kota Sato, Ryo Sasaki, Yoshiaki Takahashi, Mami Takemoto, Nozomi Hishikawa, Toru Yamashita, Takeru Asano, Tomoko Inomata, Koji Abe

Author information

Yasuyuki Ohta
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Yuko Kawahara
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Koh Tadokoro
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Kota Sato
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Ryo Sasaki
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Yoshiaki Takahashi
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Mami Takemoto
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Nozomi Hishikawa
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Toru Yamashita
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Takeru Asano
Department of Hematology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Tomoko Inomata
Department of Hematology and Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Koji Abe
Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan

Keywords: anti-ganglioside antibody, hypoglossal nerve palsy, malignant lymphoma, paraneoplastic syndrome

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 2 Pages 283-286

DOI https://doi.org/10.2169/internalmedicine.1269-18

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Abstract

Malignant lymphoma sometimes involves peripheral nerves due to paraneoplastic syndrome associated with anti-ganglioside antibodies. We report a very rare case of malignant lymphoma accompanied by an asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies. Magnetic resonance imaging and ¹⁸F-2-deoxy-2-fluoro-D-glucose position emission tomography showed no abnormalities of the hypoglossal nerve nucleus; however, the patient' s serum was positive for anti-sulfated glucuronyl paragloboside IgM antibodies as well as anti-GM1 IgM and anti-GQ1b IgM antibodies. The present case might suggest a paraneoplastic asymmetrical and isolated hypoglossal nerve palsy associated with a new subset of anti-ganglioside antibodies.

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