The recent identification of a specific autoantigen in ROHHAD patients with neural tumors and “active” disease—with positive ZSCAN1 autoantibodies both in peripheral blood and CSF, and ZSCAN1 expression in neural tumor tissues—supports the autoimmune-paraneoplastic hypothesis (Mandel-Brehm et al., 2022). The gene discussed is ZSCAN1; the disease is rapid-onset childhood obesity-hypothalamic dysfunction-hypoventilation-autonomic dysregulation syndrome.