Gluten Ataxia and mGluR1 Autoimmune Encephalitis Presenting as Acute Cerebellar Ataxia: A Case Report.
Study Goal
The researchers aimed to demonstrate the association between gluten ataxia, autoimmune encephalitis, and cerebellar ataxia, and evaluate the effectiveness of a gluten-free diet and immunotherapy in managing symptoms.
Results Summary
The study found that a gluten-free diet and intravenous immunoglobulin therapy led to mild improvements in symptoms of cerebellar ataxia in a patient with gluten ataxia and autoimmune encephalitis. The findings suggest that gluten ataxia and autoimmune encephalitis should be considered in cases of acute cerebellar ataxia.
Population
A Caucasian male in his 60s presenting with acute cerebellar ataxia.
Effective Dosage
Not specified (strict gluten-free diet and 5-day intravenous immunoglobulin therapy).
Duration
22 days (hospitalization), with ongoing gluten-free diet adherence post-discharge.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
strict gluten-free diet | decrease | symptoms (dizziness, dysarthria, gait ataxia) | Caucasian male in his 60s with acute cerebellar ataxia | mild | showed mild consecutive improvements | #1 |
intravenous immunoglobulin therapy for 5 days | decrease | symptoms (dizziness, dysarthria, gait ataxia) | Caucasian male in his 60s with acute cerebellar ataxia | mild | showed mild consecutive improvements | #2 |
broadening the differential diagnosis | increase | management | Caucasian male in his 60s with acute cerebellar ataxia | - | were beneficial | #3 |
comprehensive CSF analysis | increase | management | Caucasian male in his 60s with acute cerebellar ataxia | - | were beneficial | #4 |
A Caucasian male in his 60s presented with acute onset of dizziness, dysarthria, and gait ataxia. Upon extensive workup, positive findings were cerebrospinal fluid (CSF) showing lymphocytic pleocytosis with oligoclonal bands, positive celiac disease autoantibodies in blood, a duodenal biopsy indicating lymphocytic infiltration, and positive anti-mGluR1 antibody titers in CSF. The patient was started on a strict gluten-free diet and intravenous immunoglobulin therapy for 5 days and showed mild consecutive improvements each day of treatment. He was discharged after 22 days, and was encouraged to continue gluten adherence, physical and speech therapy, and follow up with neuroimmunology. This report demonstrates that autoimmune encephalitis due to anti-mGluR1antibodies and gluten ataxia are both immune-mediated disorders that should be considered in acute cerebellar ataxia cases. By broadening the differential diagnosis and a comprehensive CSF analysis, identification of gluten ataxia and autoimmune encephalitis were beneficial in the management of this particular patient.