Successful treatment of anti-GAD antibody-associated autoimmune cerebellar ataxia with combined immunotherapies

Yosio Omote; Chika Matsuoka; Ryo Sasaki; Nozomi Hishikawa; Yuko Kawahara; Emi Nomura; Namiko Matsumoto; Yuki Taira; Mami Takemoto; Ryuta Morihara; Toru Yamashita; Koji Abe

doi:10.1111/ncn3.12541

Successful treatment of anti-GAD antibody-associated autoimmune cerebellar ataxia with combined immunotherapies

Yosio Omote, Chika Matsuoka, Ryo Sasaki, Nozomi Hishikawa, Yuko Kawahara, Emi Nomura, Namiko Matsumoto, Yuki Taira, Mami Takemoto, Ryuta Morihara, Toru Yamashita, Koji Abe

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Journal	Neurology and Clinical Neuroscience
DOIs	https://doi.org/10.1111/ncn3.12541
Publication status	Accepted/In press - 2021

Keywords

anti-glutamic acid decarboxylase antibody
cerebellar ataxia
immunotherapy

ASJC Scopus subject areas

Neurology
Clinical Neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/ncn3.12541

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title = "Successful treatment of anti-GAD antibody-associated autoimmune cerebellar ataxia with combined immunotherapies",

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.",

keywords = "anti-glutamic acid decarboxylase antibody, cerebellar ataxia, immunotherapy",

author = "Yosio Omote and Chika Matsuoka and Ryo Sasaki and Nozomi Hishikawa and Yuko Kawahara and Emi Nomura and Namiko Matsumoto and Yuki Taira and Mami Takemoto and Ryuta Morihara and Toru Yamashita and Koji Abe",

note = "Funding Information: We appreciate the patient's cooperation. This work was partly supported by a Grant‐in‐Aid for Scientific Research (B) 17H0419611, (C) 15K0931607, 17H0975609, and 17K1082709, and by Grants‐in‐Aid from the Research Committees (Kaji R, Toba K, and Tsuji S) from the Japan Agency for Medical Research and Development 7211800049, 7211800130, and 7211700121. Publisher Copyright: {\textcopyright} 2021 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd",

year = "2021",

doi = "10.1111/ncn3.12541",

language = "English",

journal = "Neurology and Clinical Neuroscience",

issn = "2049-4173",

publisher = "Wiley-Blackwell Publishing Ltd",

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TY - JOUR

T1 - Successful treatment of anti-GAD antibody-associated autoimmune cerebellar ataxia with combined immunotherapies

AU - Omote, Yosio

AU - Matsuoka, Chika

AU - Sasaki, Ryo

AU - Hishikawa, Nozomi

AU - Kawahara, Yuko

AU - Nomura, Emi

AU - Matsumoto, Namiko

AU - Taira, Yuki

AU - Takemoto, Mami

AU - Morihara, Ryuta

AU - Yamashita, Toru

AU - Abe, Koji

N1 - Funding Information: We appreciate the patient's cooperation. This work was partly supported by a Grant‐in‐Aid for Scientific Research (B) 17H0419611, (C) 15K0931607, 17H0975609, and 17K1082709, and by Grants‐in‐Aid from the Research Committees (Kaji R, Toba K, and Tsuji S) from the Japan Agency for Medical Research and Development 7211800049, 7211800130, and 7211700121. Publisher Copyright: © 2021 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - anti-glutamic acid decarboxylase antibody

KW - cerebellar ataxia

KW - immunotherapy

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Successful treatment of anti-GAD antibody-associated autoimmune cerebellar ataxia with combined immunotherapies

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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