{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:30:03Z","timestamp":1777516203382,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Child Neurology Open"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Paraneoplastic cerebellar degeneration is rare and noteworthy in children. In this 7-year-old, it was documented to have occurred within a year of ataxia presentation. The instigating cancer was stage III adrenal adenocarcinoma, remitted after surgical resection at age 2. When her severe ataxia progressed, neuroinflammation was characterized by high cerebrospinal fluid Purkinje cell cytoplasmic antibody type 1 titers, oligoclonal bands, and neurofilament light chain. The immunotherapy strategy was to replace IV methylprednisolone, which lowered Purkinje cell cytoplasmic antibody type 1 titers without clinical improvement, with induction of adrenocorticotropic hormone\/intravenous immunoglobulin\/rituximab (ACTH\/IVIG\/rituximab) combination immunotherapy, ACTH\/dexamethasone transition, and intravenous immunoglobulin maintenance. She became self-ambulatory and cerebrospinal fluid inflammatory markers regressed. Down syndrome predisposed her to a second cancer, pre-B acute lymphoblastic leukemia, 4 years later. Despite reversible cytosine arabinoside-provoked cerebellar toxicity, the ataxia is stable on monthly intravenous immunoglobulin without relapse, now 5 years after initial diagnosis. This report illustrates the use of cerebrospinal fluid biomarkers to detect, target, and monitor neuroinflammation, and successful combinations of immunotherapy to better the quality of life.<\/jats:p>","DOI":"10.1177\/2329048x18795546","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T07:43:27Z","timestamp":1538379807000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Intensive Combination Immunotherapy and Neuroinflammation Resolution in a Child With Anti-PCA-1 (Yo) Paraneoplastic Syndrome and 2 Malignancies"],"prefix":"10.1177","volume":"5","author":[{"given":"Guillermo","family":"Philipps","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology, Golisano Children\u2019s Hospital of Southwest FL, Fort Myers, FL, USA"},{"name":"National Pediatric Myoclonus Center and National Pediatric Neuroinflammation Organization, Inc., Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth D.","family":"Tate","sequence":"additional","affiliation":[{"name":"National Pediatric Myoclonus Center and National Pediatric Neuroinflammation Organization, Inc., Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Pranzatelli","sequence":"additional","affiliation":[{"name":"National Pediatric Myoclonus Center and National Pediatric Neuroinflammation Organization, Inc., Orlando, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.328"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1789.2007.00770.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007362"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.4551"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2017.08.001"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-009-9335-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2013.11.004"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.09.006"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-018-0925-6"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-017-1802-y"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2017.12.012"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0882-0"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2017.04.027"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13015"},{"key":"e_1_3_3_16_2","article-title":"Rituximab, IVIG, and tetracosactide (ACTH 1-24) combination immunotherapy (\u201cRITE-CI\u201d) for pediatric opsoclonus-myoclonus syndrome: immunomarkers and clinical observations","author":"Pranzatelli MR","year":"2017","unstructured":"Pranzatelli MR, Tate ED, Alber M, . Rituximab, IVIG, and tetracosactide (ACTH 1-24) combination immunotherapy (\u201cRITE-CI\u201d) for pediatric opsoclonus-myoclonus syndrome: immunomarkers and clinical observations. Neuropediatrics 2017. doi: 101055\/s-0037-1609038.","journal-title":"Neuropediatrics"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2018.02.009"},{"key":"e_1_3_3_18_2","first-page":"108705471166433","article-title":"Anti-Yo antibodies in children with ADHD: First results about serum cytokines","author":"Donfrancesco R","year":"2016","unstructured":"Donfrancesco R, Nativio P, Di Benedetto A, . Anti-Yo antibodies in children with ADHD: First results about serum cytokines. J Atten Disord. 2016: pii: 10870547116643387.","journal-title":"J Atten Disord"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000433"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxlet.2009.05.024"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002808702100205"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.4.679"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1987.5.6.927"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2007.02.006"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2016.07.011"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2014.09.009"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26368"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-15297"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-014-2391-6"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2013.05.009"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-018-0478-9"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2010.02.011"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-017-9424-1"}],"container-title":["Child Neurology Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2329048X18795546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2329048X18795546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2329048X18795546","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:57:51Z","timestamp":1777391871000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2329048X18795546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1]]},"references-count":32,"alternative-id":["10.1177\/2329048X18795546"],"URL":"https:\/\/doi.org\/10.1177\/2329048x18795546","relation":{},"ISSN":["2329-048X","2329-048X"],"issn-type":[{"value":"2329-048X","type":"print"},{"value":"2329-048X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1]]},"article-number":"2329048X18795546"}}