Anti-IgLON5 disease complicated with rectal adenocarcinoma: a case report

BMC Neurol. 2023 Jan 3;23(1):1. doi: 10.1186/s12883-022-03044-y.

Abstract

Background: Anti-IgLON5 disease is a rare chronic autoimmune-mediated tauopathy, featured by the sleep disturbance. Several studies have described its clinical characteristics, however, the simultaneous occurrence of anti-IgLON5 disease and rectal cancer has not been reported. We described an unusual entity of anti-IgLON5 disease complicated with rectal cancer.

Case presentation: A 76-year-old man initially presented with slurred speech and limb tremors, followed by epileptic-like seizures, lethargy, and sleep apnea. IgG anti-IgLON5 antibodies were positive in both serum and cerebrospinal fluid. The patient responded well to the treatment of plasma exchange and a pulse and gradual reduction of steroids therapy. When the oral steroids started, mycophenolate mofetil was added. Two months later, the patient had bloody stools and pathological-confirmed moderately differentiated adenocarcinoma of the rectum.

Conclusions: Whereas sleep disturbance is the most common feature in patients with anti-IgLON5 disease, our case presented with slurred speech and limb tremors. Anti-IgLON5 disease complicated with rectal cancer is very rare. Tumor screening should be considered in patients with anti-IgLON5 disease to investigate the association between tumor and this disease.

Keywords: Autoimmune diseases; IgLON5; Immunotherapy; Movement disorders; Rectal cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Encephalitis
  • Hashimoto Disease* / complications
  • Humans
  • Male
  • Parasomnias*
  • Rectal Neoplasms* / complications
  • Sleep Apnea, Obstructive* / complications
  • Sleep Wake Disorders* / etiology
  • Tremor

Supplementary concepts

  • Hashimoto's encephalitis