{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:02:49Z","timestamp":1792501369067,"version":"4.5.0"},"reference-count":32,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Paraneoplastic autoimmune multiorgan syndrome (PAMS) is a life-threatening autoimmune disease associated with malignancies. Here, we present a patient initially misdiagnosed with \u201cchronic\u201d Stevens\u2013Johnson syndrome. Over a year later, the patient was diagnosed with stage IV follicular lymphoma and treated with an anti-CD20 antibody. At this time, his skin condition had significantly worsened, with erythroderma and massive mucosal involvement, including in the mouth, nose, eyes, and genital region. Histopathology revealed lichenoid infiltrates with interface dermatitis, dyskeratoses, necrotic keratinocytes, and a dense CD8+ infiltrate with strong epidermotropism. Direct and indirect immunofluorescence tests for autoantibodies were negative. Remarkably, we retrospectively discovered a chronic increase in peripheral CD8+ lymphocytes, persisting for over a year. Consequently, the patient was diagnosed with antibody-negative PAMS. Three weeks later, he succumbed to respiratory failure. This dramatic case highlights the challenges in diagnosing PAMS, particularly in cases where immunofluorescence assays are negative. Importantly, we observed, for the first time, a chronic excess of CD8+ peripheral blood lymphocytes, associated with PAMS, consistent with the systemic, autoreactive T-cell-driven processes that characterize this condition.<\/jats:p>","DOI":"10.3390\/curroncol29040194","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T21:40:14Z","timestamp":1648590014000},"page":"2395-2405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Antibody-Negative Paraneoplastic Autoimmune Multiorgan Syndrome (PAMS) in a Patient with Follicular Lymphoma Accompanied by an Excess of Peripheral Blood CD8+ Lymphocytes"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7862-3695","authenticated-orcid":false,"given":"Thilo","family":"Gambichler","sequence":"first","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Pei","family":"Lee","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilske","family":"Oschlies","sequence":"additional","affiliation":[{"name":"Hematopathology Section and Lymph Node Registry, Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Christian-Albrechts University, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0566-4650","authenticated-orcid":false,"given":"Christina H.","family":"Scheel","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Klapper","sequence":"additional","affiliation":[{"name":"Hematopathology Section and Lymph Node Registry, Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, Christian-Albrechts University, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Nowack","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Doerler","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"St\u00fccker","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasreddin","family":"Abolmaali","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Susok","sequence":"additional","affiliation":[{"name":"Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1056\/NEJM199012203232503","article-title":"Paraneoplastic pemphigus. 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