title: Intravenous immunoglobulin therapy for autoantibody-positive cerebellar ataxia.
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.
  
  
  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.
  
  
  CONCLUSIONS
  If cerebellar ataxia with an autoimmune mechanism is suspected and radiological findings do not reveal MSA, it is worth considering immunotherapy including IVIg.
authors.affiliation: Department of Neurology, Tokyo Medical University Hachioji Medical Center, Tokyo. synapse@tokyo-med.ac.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nanri
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Okita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takeguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ishiko
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Saito
authors.forename: Takao
authors.initials: T
authors.lastname: Otsuka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitoma
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D002524:Cerebellar Ataxia / Q000000981:diagnostic imaging / Q000276:immunology* / Q000628:therapy*; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D005903:Gliadin / Q000276:immunology; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007453:Iodide Peroxidase / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D005903:Gliadin; D007453:Iodide Peroxidase; D005968:Glutamate Decarboxylase; C059659:technetium Tc 99m bicisate; D003545:Cysteine