Anti-glutamic Acid Decarboxylase Antibody-associated Ataxia As an Extrahepatic Autoimmune Manifestation of Hepatitis C Infection: a Case Report

Overview

Journal Case Rep Neurol Med

Publisher Wiley

Specialty Neurology

Date 2012 Sep 1

PMID 22937348

Citations 3

Authors

Amer Awad

Olaf Stuve

Marlyn Mayo

Rafeed Alkawadri

Bachir Estephan

Affiliations

Soon will be listed here.

Abstract

Extrahepatic immunological manifestations of hepatitis C virus (HCV) are well described. In addition, antiglutamic acid decarboxylase (GAD) antibody-associated cerebellar ataxia is well-established entity. However, there have been no reports in the literature of anti-GAD antibody-associated ataxia as an extrahepatic manifestation of HCV infection. We report the case of a young woman with chronic hepatitis C virus and multiple extrahepatic autoimmune diseases including Sjögren syndrome and pernicious anemia who presented with subacute midline cerebellar syndrome and was found to have positive antiglutamic acid decarboxylase (GAD) antibody in the serum and cerebrospinal fluid. An extensive diagnostic workup to rule out neoplastic growths was negative, suggesting the diagnosis of nonparaneoplastic antiglutamic acid decarboxylase antibody-associated cerebellar ataxia as an additional extrahepatic manifestation of hepatitis C virus infection. The patient failed to respond to high-dose steroids and intravenous immunoglobulin. Treatment with the monoclonal antibody rituximab stabilized the disease. We postulate that anti-GAD associated ataxia could be an extrahepatic manifestation of HCV infection.

Citing Articles

Anti-glutamic acid decarboxylase antibody (GAD) syndromes may have more aggressive disease course in African Americans and early onset of presentation compare to Caucasians group.

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Clinical Spectrum of Stiff Person Syndrome: A Review of Recent Reports.

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Intravenous immunoglobulin and rituximab for cerebellar ataxia with glutamic acid decarboxylase autoantibodies.

Planche V, Marques A, Ulla M, Ruivard M, Durif F Cerebellum. 2013; 13(3):318-22.

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