Intravenous immunoglobulin and rituximab for cerebellar ataxia with glutamic acid decarboxylase autoantibodies
Cerebellum. 2013-11-12; 13(3): 318-322
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1. Cerebellum. 2014 Jun;13(3):318-22. doi: 10.1007/s12311-013-0534-3.
Intravenous immunoglobulin and rituximab for cerebellar ataxia with glutamic acid
Planche V(1), Marques A, Ulla M, Ruivard M, Durif F.
(1)Service de Neurologie, CHU Gabriel Montpied, 58 rue Montalembert, 63000,
Clermont-Ferrand, France, .
Cerebellar ataxia associated with glutamic acid decarboxylase autoantibodies
(GAD-ab) is a rare and usually slow progressive disease with moderate to severe
gait and limb ataxia, dysarthria, and nystagmus. The treatment for this condition
is still being discussed. We report the cases of three patients with GAD-ab
cerebellar ataxia treated successively with intravenous immunoglobulin (IVIg) and
rituximab. Symptoms improved in one case after rituximab therapy and were
stabilized in another after a combined therapy of IVIg and rituximab. The third
patient continued to worsen despite these treatments. We conclude that IVIg and
rituximab therapy could improve or stabilize GAD-ab cerebellar ataxia. Early
treatment, the lack of cerebellar atrophy on magnetic resonance imaging, and a
subacute onset of the symptoms could be decisive prognostic factors.
PMID: 24218114 [Indexed for MEDLINE]