Autoimmune anemia, neutropenia, Eaton-Lambert syndrome, and cerebellar degeneration in a patient with lymphoid hyperplasia.

We report a case of Coombs-positive anemia, neutropenia, Eaton-Lambert syndrome, and cerebellar degeneration with anti-Purkinje cell antibodies. No definitive cause has been established despite an extensive search for a malignancy or a known autoimmune disease. The histology of spleen and lymph nodes showed marked polyclonal B and T cell hyperplasia, noncaseating granulomas, and increased eosinophils. The disease failed to improve after splenectomy and treatment with prednisone and cyclophosphamide; partial response was achieved with azathioprine plus prednisone.