Case report: Anti-CARPVIII autoantibody-associated mixed dementia

Niels Hansen; Bianca Teegen; Sina Hirschel; Jens Wiltfang; Björn H Schott; Berend Malchow; Bartels Claudia

doi:10.3389/fpsyt.2023.1133302

Case report: Anti-CARPVIII autoantibody-associated mixed dementia

Front Psychiatry. 2023 May 5:14:1133302. doi: 10.3389/fpsyt.2023.1133302. eCollection 2023.

Authors

Niels Hansen^{1

2}, Bianca Teegen³, Sina Hirschel¹, Jens Wiltfang^{1

4

5}, Björn H Schott^{1

4

6}, Berend Malchow¹, Bartels Claudia¹

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany.
² Translational Psychoneuroscience, Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.
³ Clinical Immunological Laboratory Prof. Stöcker, Groß Grönau, Germany.
⁴ German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany.
⁵ Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
⁶ Leibniz-Institute of Neurobiology, University of Magdeburg, Magdeburg, Germany.

Abstract

Background: Anti-carbonic anhydrase-related protein VIII (CARPVIII) is reported to be associated with paraneoplastic cerebellar degeneration. Our case extends the spectrum of anti-CARPVIII-associated disease to severe cognitive impairment.

Methods: We present the case of a 75-year-old woman who presented to our Department of Psychiatry and Psychotherapy with a dementia syndrome. The diagnostic approach included magnetic resonance imaging (MRI), cerebrospinal fluid analysis (CSF) analysis involving autoantibody determination, and neuropsychological examination.

Results: Neuropsychological examination revealed severe cognitive impairment meeting the criteria for dementia. MRI showed evidence of moderate cerebral microangiopathy. CSF analysis revealed mild pleocytosis, and serum analysis revealed anti-CARPVIII autoantibodies. Based on the dementia syndrome entailing signs of CNS inflammation such as pleocytosis and the repeated detection of anti-CARPVIII autoantibodies in serum, we diagnosed autoimmune dementia as a component of mixed dementia with additional vascular dementia components.

Conclusion: Our finding adds severe cognitive impairment to the spectrum of anti-CARPVIII-associated disease. However, detecting anti-CARPVIII antibodies may also be an incidental finding in conjunction with typical mixed dementia. Further studies are needed to evaluate the relevance of these clinical findings.

Keywords: anti-CARPVIII autoantibody; autoimmunity; dementia; mixed dementia; psychiatry.

Publication types

Case Reports