Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ORIGINAL ARTICLES
Intravenous Immunoglobulin Therapy for Autoantibody-Positive Cerebellar Ataxia
Kazunori NanriMitsunori OkitaMasafumi TakeguchiTakeshi TaguchiTomoko IshikoHirohiko SaitoTakao OtsukaHiroshi MitomaKiyoshi Koizumi
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JOURNALS OPEN ACCESS

2009 Volume 48 Issue 10 Pages 783-790

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Abstract

Objective It has been reported that autoimmune cerebellar ataxias, such as anti-glutamic acid decarboxylase (GAD)-antibody-positive cerebellar ataxia and gluten ataxia, are treatable. Here, we examined the therapeutic efficacy of intravenous immunoglobulin (IVIg) on autoantibody-positive cerebellar ataxia.
Patients and Methods IVIg therapy was administered in seven autoantibody-positive cerebellar ataxia patients. Therapeutic efficacy was examined in terms of its effects on clinical symptoms and changes in brain perfusion using single photon emission computed tomography (SPECT).
Results Treatment was effective in four cerebellar cortical atrophy patients (two anti-GAD antibody-positive and two anti-gliadin antibody-positive) and in one anti-thyroid antibody-positive spinocerebellar ataxia type 3 (SCA3) patient, but not in two multiple system atrophy (MSA) patients. All four IVIg effective patients who underwent SPECT showed apparent increases in cerebellar perfusion.
Conclusion If cerebellar ataxia with an autoimmune mechanism is suspected and radiological findings do not reveal MSA, it is worth considering immunotherapy including IVIg.

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© 2009 by The Japanese Society of Internal Medicine
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