Hiperglisemi ve paraneoplastik antikor pozitifliği etyolojili nadir bir hemikore olgusu

Year 2025, Volume: 16 Issue: 2, 423 - 427, 30.06.2025

Fatma Ebru Algül

https://doi.org/10.18663/tjcl.1594866

Abstract

Kore bir çok nörolojik ve metabolik bozukluk sebebi ile ortaya çıkabilen etyolojisi çok geniş bir hareket bozukluğudur. Hiperglisemi esık gözüken metabolik sebep iken, paraneoplastik bozukluklar da nadir görülen sebeplerden bir tanesidir. Biz de bu olgu sunumu ile literatürde nadir görülen anti-Yo antikor pozitifliği ve hiperglisemi ile ilişkili bir hemikore olgusu sunmayı planladık.
1,5 ay önce kanşeker yüksekliği ile diabet tanısı alan, o dönemden itibaren sağ kol va bacakta istemsiz hareketleri olması nedeni ile başvuran yapılan incelemelerde etyolojide anti-Yo antikoru pozitifliği ile birlikte hiperglisemi tespit edilen, kranial görüntülemede hiperglisemik hemikore tanısı ile uyumlu olarak sol bazal ganglionda lezyon tespit edilen, 68 yaşında bir hasta sunduk.
Hemikore şikayeti ile başvuran hastalarda etyoloji araştırılırken öncelikle kanşekeri kontrolü yapılması önemlidir. Etyolojide farklı mekanizmaların da rol oynayabileceği, paraneoplastik kore açısından değerlendirme ve gerekirse malignite taraması yapılması da akılda tutulmalıdır.

Keywords

kore, , hiperglisemi , paraneoplastik

A rare case of hemichorea wıth hyperglycemia and paraneoplastic antibody positive etiology

Abstract

Chorea is a movement disorder with a very wide etiology that can occur due to many neurological and metabolic disorders. Hyperglycemia is a commonly observed metabolic cause, while paraneoplastic disorders are one of the rare causes. In this case presentation, we aim to present a rare case of hemichorea associated with anti-Yo antibody positivity and hyperglycemia, which has been rarely reported in the literature.
We presented a patient 68 year old that was diagnosed as diabetes with high blood sugar 1.5 months ago . He applied because of involuntary movements in the right arm and right leg since than 1.5 months. Hyperglycemia with anti-Yo antibody positivity in etiology. A lesion in the left basal ganglia that matches with the diagnosis of hyperglycemic hemichorea was detected in the cranial magnetic resonance.
It is important to check the blood sugar firstly when investigating the etiology in patients who applies with the complaint of hemichorea. Different mechanisms may play role in the etiology. Therefore, evaluation of the case in terms of paraneoplastic chorea and, if necessary, screening for malignancy should also be kept in mind.

Keywords

chorea, , hyperglycemia , paraneoplastic

References

• Chen C, Zheng H, Yang L, Hu Z. Chorea-ballism associated with ketotic hyperglycemia. Neurol Sci. 2014;35(12):1851-1855.
• Narayanan S. Hyperglycemia-induced hemiballismus hemichorea: a case report and brief review of the literature. J Emerg Med. 2012;43(3):442-444.
• Aydin D, Somnier F, Lassen LH. Paraneoplastic choreoathetosis in a patient with small cell lung carcinoma and anti-CRMP5/CV2: a case report. Case Rep Neurol 2016;8(1):16–19.
• Bedwell SF. Some observations on hemiballismus. Neurology 1960;10:619-22.
• Ahlskog JE, Nishino H, Evidente VG, Tulloch JW, Forbes GS, Caviness JN,Gwinn-Hardy KA. Persistent chorea triggered by hyperglycemic crisis in diabetics.Mov Disord. 2001;16:890-898.
• Shafran I, Greenberg G, Grossman E, Leibowitz A. Diabetic striatopathy—does it exist in non-Asian subjects?. Eur J Intern Med. 2016;35:51-54.
• Bhagwat NM, Joshi AS, Rao G, Varthakavi PK (2013). Uncontrolled hyperglycaemia: a reversible cause of hemichorea-hemiballismus. BMJ Case Rep 2013:bcr2013010229.
• Chang X, Hong W, Yu H, Yao Y. Chorea associated with nonketotic hyperglycemia: a case report with atypical imaging changes. Medicine (Baltimore) 2017;96(45):e8602.
• Ondo WG. Hyperglycemic nonketotic states and other metabolic imbalances. Handb Clin Neurol. 2011;100:287-91.
• Hsu JL, Wang HC, Hsu WC. Hyperglycemia-induced unilateral basal ganglion lesions with and without hemichorea: a PET study. J Neurol 2004;251:1486-1490.
• Kocasoy Orhan E, Atmaca MM, Atmaca M, Hanağasi HA. Chorea-Ballismus Associated with Hyperglycemia. Noro Psikiyatr Ars. 2013 Dec;50(4):375-378. doi: 10.4274/npa.y6468.
• Postuma RB, Lang AE. Hemiballism: revisiting a classic disorder. Lancet Neurol 2003;2:661-668.
• Kyle K, Bordelon Y, Venna N, Linnoila J. Autoimmune and Paraneoplastic Chorea: A Review of the Literature. Front Neurol. 2022 Mar 18;13:829076.
• Le May M, Dent S. Anti-Yo antibody–mediated paraneoplastic cerebellar degeneration associated with cognitive affective syndrome in a patient with breast cancer: a case report and literature review[J]. Curr Oncol 2018;25(6):585–591
• Ren M, Zhou Q. Stroke-like presentation of autoimmune chorea with positive anti-Yo and anti-MOG antibodies: a case report. Neurol Sci. 2023 Jan;44(1):347-349
• Goldstein L, Djaldetti R, Benninger F. Anti-Yo, chorea and hemiballismus: a case report. J Clin Neurosci 2017;045(03):42.