https://doi.org/10.4081/ejtm.2023.11557

Combined effect of medical therapy and rehabilitation in Chronic Ataxic Neuropathy with anti-Disialosyl IgM Antibodies (CANDA): a case report

Vol. 33 No. 3 (2023)
Submitted: 30 June 2023
Accepted: 17 July 2023
Published: 31 July 2023
chronic ataxic neuropathy, CANDA, anti-disialosyl antibodies, rehabilitation, muscle exercise
Abstract Views: 779
PDF: 161
HTML: 14
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Giulio Balestro
https://orcid.org/0009-0008-7271-9352
Unit of Neurorehabilitation, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy.
Alessandro Picelli
Unit of Neurorehabilitation, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital of Verona, University of Verona, Verona, Italy.
Luca Ortolani
https://orcid.org/0009-0009-2412-6410
U.O.C. Recovery and Functional Rehabilitation – Lonigo, Ulss8 Berica, Italy.
Andrea Marcante
andrea.marcante@aulss8.veneto.it
U.O.C. Recovery and Functional Rehabilitation – Lonigo, Ulss8 Berica, Italy.

Chronic Ataxic Neuropathy with anti-Disialosyl IgM Antibodies (CANDA) is a rare form of immune-mediated sensory ataxic neuropathy. We describe the case of a 45-year-old man, who was diagnosed with CANDA in October 2018. Since then, he has been treated with monthly courses of intravenous immunoglobulin administration (IV Ig) and, in October 2022, he underwent plasmapheresis, reporting a sudden worsening of clinical and motor picture. After a new IV Ig cycle admission, the patient was hospitalized to perform intensive rehabilitation, involving two individual sessions per day (90 minutes each) for 5 days a week. During hospitalization it was registered a relevant improvement in the muscle strength of the lower limbs (LLs). Furthermore, progressive improvements were recorded both in patient's motor performance and in his level of autonomy in activities of daily living. These results had a positive impact on his quality of life and made it possible to reduce the frequency of IV Ig treatments. This is the first case in literature reporting the combined effect of rehabilitation treatment and medical therapy in CANDA neuropathy.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Garcia-Santibanez R, Zaidman CM, Sommerville RB, Lopate G, Weihl CC, Pestronk A, Bucelli RC. CANOMAD and other chronic ataxic neuropathies with disialosyl antibodies (CANDA). J Neurol. 2018 Jun;265(6):1402-1409. Epub 2018 Apr 9. PMID: 29633012. DOI: https://doi.org/10.1007/s00415-018-8853-4
Willison HJ, O'Leary CP, Veitch J, Blumhardt LD, Busby M, Donaghy M, Fuhr P, Ford H, Hahn A, Renaud S, Katifi HA, Ponsford S, Reuber M, Steck A, Sutton I, Schady W, Thomas PK, Thompson AJ, Vallat JM, Winer J. The clinical and laboratory features of chronic sensory ataxic neuropathy with anti-disialosyl IgM antibodies. Brain. 2001 Oct;124(Pt 10):1968-77. PMID: 11571215. DOI: https://doi.org/10.1093/brain/124.10.1968
Peillet C, Adams D, Attarian S, Bouhour F, Cauquil C, Cassereau J, Chanson JB, Cintas P, Creange A, Delmont E, Fargeot G, Genestet S, Gueguen A, Kaminsky AL, Kuntzer T, Labeyrie C, Michaud M, Pereon Y, Puma A, Viala K, Chretien P, Adam C, Echaniz-Laguna A. Anti-disialosyl-immunoglobulin M chronic autoimmune neuropathies: a nationwide multicenter retrospective study. Eur J Neurol. 2022 Dec;29(12):3547-3555. Epub 2022 Aug 29. PMID: 35969369. DOI: https://doi.org/10.1111/ene.15523
Yuki N, Uncini A. Acute and chronic ataxic neuropathies with disialosyl antibodies: a continuous clinical spectrum and a common pathophysiological mechanism. Muscle Nerve. 2014 May;49(5):629-35. Epub 2014 Feb 28. PMID: 24477718. DOI: https://doi.org/10.1002/mus.24192
Vallat JM, Deschamps N, Taithe F, Richard L, Duchesne M, Magy L, Mathis S. Are Miller Fisher syndrome and CANDA due to a paranodopathy? J Neurol Sci. 2022 Jul 15;438:120279. Epub 2022 May 10. PMID: 35576641. DOI: https://doi.org/10.1016/j.jns.2022.120279
Marastoni D, Africa L, Peretti A, Bocci S, Insana L, Ferrari S, Ginanneschi F, Zanette G, Fabrizi GM, Giannini F. Sustained response to subcutaneous immunoglobulins in chronic ataxic neuropathy with anti-disialosyl IgM antibodies (CANDA): report of two cases and review of the literature. J Neurol. 2020 Aug;267(8):2353-2361. Epub 2020 Apr 28. PMID: 32347337. DOI: https://doi.org/10.1007/s00415-020-09843-y
Mahoney FI, Barthel DW. Functional evaluation: the Barthel index. Md State Med J. 1965 Feb;14:61-5. PMID: 14258950. DOI: https://doi.org/10.1037/t02366-000
Ravaud JF, Delcey M, Yelnik A. Construct validity of the functional independence measure (FIM): questioning the unidimensionality of the scale and the "value" of FIM scores. Scand J Rehabil Med. 1999 Mar;31(1):31-41. PMID: 10230001. DOI: https://doi.org/10.1080/003655099444704
Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O'Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures. Brain. 2010 Oct;133(10):2838-44. PMID: 20928945. DOI: https://doi.org/10.1093/brain/awq270
Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998 Nov;51(11):1171-8. PMID: 9817135. DOI: https://doi.org/10.1016/S0895-4356(98)00109-7
Idiaquez JF, Alcantara M, Bril V. Optimal cut-off value of the modified Toronto Clinical Neuropathy Score in the diagnosis of polyneuropathy. Eur J Neurol. 2023 May 19. Epub ahead of print. PMID: 37203998. DOI: https://doi.org/10.1111/ene.15870
Kern H, Hofer C, Loefler S, Zampieri S, Gargiulo P, Baba A, Marcante A, Piccione F, Pond A, Carraro U. Atrophy, ultra-structural disorders, severe atrophy and degeneration of denervated human muscle in SCI and Aging. Implications for their recovery by Functional Electrical Stimulation, updated 2017. Neurol Res. 2017 Jul;39(7):660-666. Epub 2017 Apr 13. PMID: 28403681. DOI: https://doi.org/10.1080/01616412.2017.1314906
Grewal GS, Sayeed R, Schwenk M, Bharara M, Menzies R, Talal TK, Armstrong DG, Najafi B. Balance rehabilitation: promoting the role of virtual reality in patients with diabetic peripheral neuropathy. J Am Podiatr Med Assoc. 2013 Nov-Dec;103(6):498-507. PMID: 24297986. DOI: https://doi.org/10.7547/1030498

How to Cite

Balestro, G., Picelli, A., Ortolani, L., & Marcante, A. (2023). Combined effect of medical therapy and rehabilitation in Chronic Ataxic Neuropathy with anti-Disialosyl IgM Antibodies (CANDA): a case report. European Journal of Translational Myology, 33(3). https://doi.org/10.4081/ejtm.2023.11557
Copyright (c) 2023 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.