Journal article
Autoimmune cerebellar ataxia with initial seronegativity and low‐titer anti‐glutamic acid decarboxylase antibody in the cerebrospinal fluid
Clinical & experimental neuroimmunology, Vol.8(2), pp.158-161
05/2017
DOI: 10.1111/cen3.12381
Abstract
Background In cases with anti‐glutamic acid decarboxylase (GAD) antibody‐positive cerebellar ataxia, the titer of the antibody is usually very high. However, a few cases of low‐titer GAD antibody‐positive cerebellar ataxia patients have been described recently. In such patients, the antibody has been detected predominantly in serum, rather than in cerebrospinal fluid. Case presentation A 34‐year‐old man presented with subacute‐onset cerebellar ataxia, and examinations revealed no abnormal findings except low‐titer anti‐GAD antibody in the cerebrospinal fluid at initial evaluation: the serum antibody became slightly positive in a delayed manner. Treatment with steroid and/or immunoglobulin was effective in improving symptoms, and the effect of these treatments continued for approximately 1 year. Conclusions The present case suggested a potential diagnostic pitfall, in which the examination of serum anti‐GAD antibody at initial evaluation alone might be insufficient to rule out this disease. It may be indicated that the routine screening should include examination for the GAD antibody in both the serum and cerebrospinal fluid, plus additional follow‐up checks for the antibody in the subsequent clinical course. Care must be taken to avoid non‐detection of this disease with possibly reversible symptoms in patients with cerebellar ataxia of unknown origin. A case of 34‐year‐old man presenting with low‐titer GAD‐Ab positive cerebellar ataxia (AGCA), who on initial evaluation showed elevated GAD‐Ab in the CSF but not in the serum, and his serum titer elevated in a delayed manner. It may be indicated that routine screening for adult‐onset acute or subacute cerebellar ataxia should include examination for GAD‐Ab in both serum and CSF, plus additional follow‐up checks for the antibody in the subsequent clinical course.
Details
- Title: Subtitle
- Autoimmune cerebellar ataxia with initial seronegativity and low‐titer anti‐glutamic acid decarboxylase antibody in the cerebrospinal fluid
- Creators
- Kenichiro Sato - National Center for Global Health and MedicineNoritoshi Arai - National Center for Global Health and MedicineTaro Bannai - National Center for Global Health and MedicineSatoshi Kodama - National Center for Global Health and MedicineAki Omori-Mitsue - National Center for Global Health and MedicineAyumi Hida - National Center for Global Health and MedicineSousuke Takeuchi - National Center for Global Health and Medicine
- Resource Type
- Journal article
- Publication Details
- Clinical & experimental neuroimmunology, Vol.8(2), pp.158-161
- DOI
- 10.1111/cen3.12381
- ISSN
- 1759-1961
- eISSN
- 1759-1961
- Number of pages
- 4
- Grant note
- Grants‐in‐Aid for Research from the National Center for Global Health and Medicine (26A‐201)
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Neurology
- Record Identifier
- 9985178663902771
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