Successful treatment of anti‐GAD antibody‐associated autoimmune cerebellar ataxia with combined immunotherapies. Issue 6 (4th September 2021)

• Record Type: Journal Article
• Authors: Omote, Yoshio; Matsuoka, Chika; Sasaki, Ryo; Hishikawa, Nozomi; Kawahara, Yuko; Nomura, Emi; Matsumoto, Namiko; Taira, Yuki; Takemoto, Mami; Morihara, Ryuta; Yamashita, Toru; Abe, Koji
• Is Part Of: Neurology and clinical neuroscience. Volume 9:Issue 6(2021)
• Page Start: 474
• Page End: 477
• Publication Date: 2021-09-04
• Subjects: anti‐glutamic acid decarboxylase antibody -- cerebellar ataxia -- immunotherapy; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8
• DOI: 10.1111/ncn3.12541
• Languages: English
• ISSNs: 2049-4173

Abstract

Abstract: Anti‐glutamic acid decarboxylase (GAD) antibody (Ab)‐associated autoimmune cerebellar ataxia (CA) is a rare neurological disorder, and a standardized therapy has not been established. Here, we report on a 58 year‐old man with type 1 diabetes mellitus, who developed progressive CA with high levels of serum and cerebrospinal fluid (CSF) anti‐GAD‐Ab. He was initially treated with intravenous high‐dose methylprednisolone and intravenous immunoglobulin (IVIg), but his CA was gradually worsened. Additional combined immunotherapies with plasma exchange, intravenous cyclophosphamide, and rituximab finally stabilized the progressive CA and suppressed the CSF anti‐GAD‐Ab index. Our case suggests the effectiveness of combined immunotherapies against progressive CA and the usefulness of the CSF anti‐GAD‐Ab index as a therapeutic indicator.