{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:41:45Z","timestamp":1786959705870,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["cerebellum ataxias"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Paraneoplastic cerebellar degeneration (PCD) is a classic neurological syndrome where the presence of Anti-Tr\/DNER antibodies is strongly associated with Hodgkin Lymphoma (HL). Awareness of the syndrome is important because with prompt treatment the prognosis of HL is good. The diagnosis can be a challenge in some patients. The importance of PCD in the detection of a cancer relapse is not clarified. We report the case of a 76-year-old man where a PCD, initially misdiagnosed as a stroke led to a diagnosis of a very late relapse of HL after 12 years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 76-year-old male with a 3-week history of unstable walking, slow speech and dizziness was admitted to our stroke unit apparently because the symptoms started acutely. With a diagnostic delay of 3\u20134 weeks a correct diagnosis of relapse HL was made based on cerebrospinal fluid changes with a strong positive reaction to anti-Tr\/DNER antibodies, FDG-PET\/CT scan, and biopsy findings. The medical history revealed that the patient had been diagnosed with HL previously, but has been in complete remission for 12 years. The patient was treated with intravenous immunoglobulin, chemo- and radiation therapy. Over the following 6\u20138 weeks he improved.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Late relapse in HL is very rare. If it occurs it presents as a symptomatic lymphadenopathy. Our case shows, that PCD can be the only presenting symptom of a very late relapse of HL. Paraneoplastic neurological syndromes (PNS) should be considered even in patients with very long cancer remission. PCD can in rare cases mimic a stroke within the posterior circulation. If MR imaging in severe acute\/subacute cerebellar syndrome is normal further investigation is mandatory to rule out a PNS, particular in patients with a previous cancer.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40673-021-00137-1","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T13:02:33Z","timestamp":1622898153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Anti-Tr\/DNER antibody paraneoplastic cerebellar degeneration preceding a very late relapse of Hodgkin Lymphoma after 12 years"],"prefix":"10.1186","volume":"8","author":[{"given":"Peter Broegger","family":"Christensen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Gregersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Almasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"137_CR1","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1212\/WNL.42.10.1938","volume":"42","author":"J Hammack","year":"1992","unstructured":"Hammack J, Kotanides H, Rosenblum MS, Posner JB. Paraneoplastic cerebellar degeneration: II. Clinical and immunologic findings in 21 patients with Hodgkin\u00b4s disease. Neurology. 1992;42:1938\u201343.","journal-title":"Neurology"},{"key":"137_CR2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1212\/01.WNL.0000041495.87539.98","volume":"60","author":"F Bernal","year":"2003","unstructured":"Bernal F, Shams\u00b4ili S, Rojas R, Sanchez-Valle R, Saiz A, Dalmau J, et al. Anti-Tr antibodies as markers of paraneoplastic cerebellar degeneration and Hodgkin`s disease. Neurology. 2003;60:230\u201334.","journal-title":"Neurology"},{"issue":"21","key":"137_CR3","doi-asserted-by":"publisher","first-page":"3220","DOI":"10.1182\/blood-2014-03-537506","volume":"123","author":"F Graus","year":"2014","unstructured":"Graus F, Arino H, Dalmau J. Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas. 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JAMA Neurol. 2014;71(8):1003\u20138.","journal-title":"JAMA Neurol"},{"issue":"1","key":"137_CR10","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1056\/NEJM200001063420104","volume":"342","author":"P Sillevis Smitt","year":"2000","unstructured":"Sillevis Smitt P, Kinoshita A, De Leeuw B, Moll W, Coesmans M, Jaarsma D, et al. Paraneoplastic cerebellar ataxia due to autoantibodies to a glutamate receptor. N Engl J Med. 2000;342(1):21\u20137.","journal-title":"N Engl J Med"},{"key":"137_CR11","doi-asserted-by":"publisher","first-page":"1698","DOI":"10.1212\/WNL.0b013e3182364a44","volume":"77","author":"E Lancaster","year":"2011","unstructured":"Lancaster E, Martinez-Hernandez E, Titulaer MJ, Boulos M, Weaver S, Antoine JC, et al. Antibodies to the metabotropic glutamate receptor 5 in Ophelia syndrome. Neurology. 2011;77:1698\u201301.","journal-title":"Neurology"}],"container-title":["Cerebellum &amp; Ataxias"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40673-021-00137-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40673-021-00137-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40673-021-00137-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T13:08:58Z","timestamp":1622898538000},"score":1,"resource":{"primary":{"URL":"https:\/\/cerebellumandataxias.biomedcentral.com\/articles\/10.1186\/s40673-021-00137-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,5]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["137"],"URL":"https:\/\/doi.org\/10.1186\/s40673-021-00137-1","relation":{},"ISSN":["2053-8871"],"issn-type":[{"value":"2053-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,5]]},"assertion":[{"value":"31 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. Ethics approval is not required for a case report in Denmark.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this paper and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"14"}}