To summarize the evidence of cases of anti-Yo positive PCD patients.

Paraneoplastic Cerebellar Degeneration (PCD) is the second most frequent paraneoplastic syndrome and the second most common immune-mediated cerebellar ataxia (IMCA). Multiple onconeural antibodies were detected in these patients, especially the anti-Yo which is usually associated with malignant breast and gynecological tumors.

We searched 5 databases (PubMed, Embase, Scopus, Web of Science and Google Scholar) until April 2024. A total of 110 studies including 120 PCD cases were included. No meta-analysis was performed due to the heterogeneity of the data. We included all case reports or case series describing the clinical, diagnostic and treatment characteristics of patients with Anti-Yo positive PCD. The JBI critical appraisal tool was used to assess the risk of bias of case reports and cases series.

We included 110 studies with 120 cases. The main clinical manifestations of patients were mild symptoms such as unsteady gait (80%), double vision (75%) and difficulty with fine hand movements (60%), in some cases these symptoms have progressed to limb ataxia (20%). Most patients received immunotherapy such as intravenous immunoglobulins (60%) and plasmapheresis (45%). Also, most patients presented comorbidity with breast (75%) and gynecological cancer (50%) and with other types of cancer (15%). Additionally, all studies reported a low risk of bias.

Most cases of anti-Yo positive PCD are associated with breast and gynecologic cancers, and immunoglobulin therapy is the first line of therapy. However, future clinical trials and prospective studies evaluating these patients are required.