Table 2

Paraneoplastic antibodies associated with rhomboencephalitis

Antigen locationAntibodyOncological associationTreatment
IntracellularAnti-Hu (ANNA-1)Small-cell lung cancerCancer targeted therapy±immunosuppression*
Anti-Ri (ANNA-2)Breast, lungCancer targeted therapy±immunosuppression
Anti-Ma2Testicular germ cell tumourCancer targeted therapy±immunosuppression
Less common paraneoplastic antineuronal antibodies: anti-Yo, Anti-Tr, antiamphiphysin, Breast, gynaecological, small-cell lung cancer and Hodgkin’s lymphoma (anti-Yo); Hodgkin’s lymphoma (anti-Tr); breast and small-cell lung cancer (anti-amphiphysin); Cancer targeted therapy±immunosuppression
Cell surfaceAnti-NMDAOvarian teratomaImmunosuppression±cancer targeted therapy
Anti-IgLON5None currentlyImmunosuppression
Antiglycine receptorBreast, thymoma, Hodgkin’s lymphomaImmunosuppression±cancer targeted therapy
Less common: anti-DPPX Lymphoma Immunosuppression±cancer targeted therapy
  • *Immunosuppression is usually with high-dose corticosteroids and either intravenous immunoglobulin or plasma exchange first line followed by rituximab or cyclophosphamide.

  • ANNA, antineuronal nuclear antibody; DPPX, dipeptidyl-peptidase-like protein 6; IgLON5, immunoglobulin-like cell adhesion molecule 5; NMDA, N-methyl-D-aspartate.