title: Gluten ataxia in Japan.
abstract: Gluten ataxia, a type of cerebellar ataxia caused by exposure to gluten in sensitive patients, has been considered common in the USA and Europe, and rare in Asia. We measured anti-deamidated gliadin peptide (DGP) antibody levels in 49 patients with cerebellar ataxia, excluding those with multiple system atrophy, hereditary spinocerebellar ataxia, or cancer, as well as those who were receiving oral administration of phenytoin. Anti-DGP antibody was positive in eight (16.3 %) patients, five of these patients were positive only for IgA, one was positive for both IgG and IgA, and two were positive only for IgG antibody. Intravenous immunoglobulin was administered to five of the eight patients, and was markedly effective in one, moderately effective in two, and ineffective in two. Steroid therapy was administered to four patients, but none had an apparent response. Ataxia symptoms improved in one patient treated with a gluten-free diet only. Although it had been thought to be extremely rare in Asia, we speculate that more than 10 % of cerebellar ataxia patients in Japan currently have gluten ataxia; therefore, measuring anti-DGP antibody or anti-gliadin antibody in cerebellar ataxia patients in Asia is important.
authors.affiliation: Department of Neurology, Hachioji Medical Center, Tokyo Medical University, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan, synapse@tokyo-med.ac.jp.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nanri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitoma
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ihara
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Taguchi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takeguchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ishiko
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Mizusawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001921:Brain / Q000473:pathology; D002524:Cerebellar Ataxia / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D055050:Diet, Gluten-Free; D005260:Female; D005903:Gliadin / Q000276:immunology*; D005983:Glutens / Q000009:adverse effects*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D013256:Steroids; D005983:Glutens; D005903:Gliadin