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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">nnp</journal-id><journal-title-group><journal-title xml:lang="en">Neurology, Neuropsychiatry, Psychosomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>Неврология, нейропсихиатрия, психосоматика</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2074-2711</issn><issn pub-type="epub">2310-1342</issn><publisher><publisher-name>"IMA-Press", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/2074-2711-2020-5-66-70</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-1449</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL OBSERVATIONS</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group></article-categories><title-group><article-title>Ataxia associated with anti-glutamic acid decarboxylase antibodies</article-title><trans-title-group xml:lang="ru"><trans-title>Атаксия, ассоциированная с антителами к глутаматдекарбоксилазе</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нужный</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Nuzhnyi</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Евгений Петрович Нужный</p><p>125367, Москва, Волоколамское шоссе, 80 </p><p> </p></bio><bio xml:lang="en"><p>Evgeny P. Nuzhnyi</p><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><email xlink:type="simple">enuzhny@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Краснов</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Krasnov</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>125367, Москва, Волоколамское шоссе, 80 </p></bio><bio xml:lang="en"><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахмадуллина</surname><given-names>Д. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Akhmadullina</surname><given-names>D. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>125367, Москва, Волоколамское шоссе, 80 </p></bio><bio xml:lang="en"><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абрамова</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Abramova</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>125367, Москва, Волоколамское шоссе, 80 </p></bio><bio xml:lang="en"><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Федотова</surname><given-names>Е. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Fedotova</surname><given-names>E. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>125367, Москва, Волоколамское шоссе, 80 </p></bio><bio xml:lang="en"><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иллариошкин</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Illarioshkin</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>125367, Москва, Волоколамское шоссе, 80 </p></bio><bio xml:lang="en"><p>80, Volokolamskoe Shosse, Moscow 125367</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научный центр неврологии»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Center of Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>25</day><month>10</month><year>2020</year></pub-date><volume>12</volume><issue>5</issue><fpage>66</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Nuzhnyi E.P., Krasnov M.Y., Akhmadullina D.R., Abramova A.A., Fedotova E.Y., Illarioshkin S.N., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Нужный Е.П., Краснов М.Ю., Ахмадуллина Д.Р., Абрамова А.А., Федотова Е.Ю., Иллариошкин С.Н.</copyright-holder><copyright-holder xml:lang="en">Nuzhnyi E.P., Krasnov M.Y., Akhmadullina D.R., Abramova A.A., Fedotova E.Y., Illarioshkin S.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://nnp.ima-press.net/nnp/article/view/1449">https://nnp.ima-press.net/nnp/article/view/1449</self-uri><abstract><p>Anti-glutamic acid decarboxylase (GAD) antibody-associated ataxia is a rarely diagnosed but potentially curable disease associated with autoimmune damage to and death of Purkinje cells in the cerebellar cortex. In Russia, the authors have provided for the first time descriptions of three own observations of this disease, which had a number of clinical features, such as slow progression, mild ataxia, stroke-like episodes with stem symptoms, concomitant gluten sensitivity, onset of ataxia after hepatitis C with cerebellar hemiataxia and hemiatrophy. In the all patients, the diagnosis was verified based on the determination of high anti-GAD antibody titers in serum and cerebrospinal fluid. All the patients lacked intrathecal synthesis of oligoclonal antibodies; protein levels and cytosis were normal. Pulse therapy with methylprednisolone at a total dose of 3–5 g led to a slight reduction in ataxia in one case (a female patient with subacute onset of the disease); the treatment was ineffective in two other cases (patients with a primary chronic course). The paper analyzes the literature covering the pathogenesis and clinical presentations of this type of ataxia, and difficulties in its diagnosis and treatment.</p></abstract><trans-abstract xml:lang="ru"><p>диагностируемым, но потенциально излечимым заболеванием, связанным с аутоиммунным поражением и гибелью клеток Пуркинье коры мозжечка. Нами впервые в России приведены описания трех собственных наблюдений данного заболевания, которые имели ряд клинических особенностей, таких как медленное прогрессирование, легкая степень выраженности атаксии, инсультоподобные эпизоды со стволовой симптоматикой, сопутствующая чувствительность к глютену, дебют атаксии после гепатита С с гемиатаксией и гемиатрофией полушария мозжечка. Всем пациентам диагноз был верифицирован на основании определения высоких титров антител к GAD в сыворотке крови и цереброспинальной жидкости. У всех пациентов нашей выборки отсутствовал интратекальный синтез олигоклональных антител, уровень белка и цитоз были в норме. Пульс-терапия метилпреднизолоном в суммарной дозе 3–5 г в одном случае (у пациентки с подострым началом заболевания) привела к незначительному уменьшению атаксии, в двух других случаях (пациенты с первично-хроническим течением) лечение было неэффективным. Приведен анализ литературы с освещением патогенеза, клинической картины, а также трудностей диагностики и лечения данного типа атаксии.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>атаксия</kwd><kwd>глутаматдекарбоксилаза</kwd><kwd>антитела</kwd><kwd>клиническая картина</kwd><kwd>диагностика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ataxia</kwd><kwd>glutamic acid decarboxylase</kwd><kwd>antibodies</kwd><kwd>clinical presentation</kwd><kwd>diagnosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mitoma H, Hadjivassiliou M, Honnorat J. Guidelines for treatment of immune-mediated cerebellar ataxias. Cerebellum Ataxias. 2015 Nov 10;2:14. doi: 10.1186/s40673-015-0034-y. eCollection 2015.</mixed-citation><mixed-citation xml:lang="en">Mitoma H, Hadjivassiliou M, Honnorat J. Guidelines for treatment of immune-mediated cerebellar ataxias. Cerebellum Ataxias. 2015 Nov 10;2:14. doi: 10.1186/s40673-015-0034-y. eCollection 2015.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Hadjivassiliou M, Boscolo S, Tongiorgi E, et al. Cerebellar ataxia as a possible organ specific autoimmune disease. Movement Disord. 2008 Jul 30;23(10):1370-7. doi: 10.1002/mds.22129</mixed-citation><mixed-citation xml:lang="en">Hadjivassiliou M, Boscolo S, Tongiorgi E, et al. Cerebellar ataxia as a possible organ specific autoimmune disease. Movement Disord. 2008 Jul 30;23(10):1370-7. doi: 10.1002/mds.22129</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Baizabal-Carvallo JF. The neurological syndromes associated with glutamic acid decarboxylase antibodies. J Autoimmun. 2019 Jul;101:35-47. doi: 10.1016/j.jaut.2019.04.007. Epub 2019 Apr 15.</mixed-citation><mixed-citation xml:lang="en">Baizabal-Carvallo JF. The neurological syndromes associated with glutamic acid decarboxylase antibodies. J Autoimmun. 2019 Jul;101:35-47. doi: 10.1016/j.jaut.2019.04.007. Epub 2019 Apr 15.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Исаева НВ, Прокопенко СВ, Родиков МВ и др. Синдром ригидного человека: особенности клинического течения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019;119(6):96-100. doi: 10.17116/jnevro201911906196</mixed-citation><mixed-citation xml:lang="en">Isaeva NV, Prokopenko SV, Rodikov MV, et al. Сlinical features of stiff-person syndrome. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(6):96-100. doi: 10.17116/jnevro201911906196 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Краснов МЮ, Павлов ЭВ, Ершова МВ и др. Спектр неврологических синдромов, ассоциированных с антителами к глутаматдекарбоксилазе. Анналы клинической и экспериментальной неврологии. 2015;9(4):37-41.</mixed-citation><mixed-citation xml:lang="en">Krasnov MYu, Pavlov EV, Ershova MV, et al. The range of neurological syndromes associated with glutamic acid decarboxylase antibodies. Annaly klinicheskoy i experimental'noy nevrologii. 2015;9(4):37-41 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Сердюк АВ, Ковражкина ЕА. Синдром ригидного человека с миоклонусом и дизавтономией: описание случая. Consilium Medicum. 2017;19(9):65-8. doi: 10.26442/2075-1753_19.9.65-68</mixed-citation><mixed-citation xml:lang="en">Serdjuk AV, Kovrazhkina EA. A case report of stiff-person syndrome with myoclonus and dysautonomia. Consilium Medicum. 2017;19(9):65-8. doi: 10.26442/2075-1753_19.9.65-68 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Сорокина ЕА, Ельчанинов ДВ, Плотникова АА и др. Синдром ригидного человека. Неврологический журнал. 2018;23(4):195-200. doi: 10.18821/1560-9545-2018-23-4-195-200</mixed-citation><mixed-citation xml:lang="en">Sorokina EA, El'chaninov DV, Plotnikova AA, et al. Stiff-person syndrome. Nevrologicheskii zhurnal. 2018;23(4):195-200. doi: 10.18821/1560-9545-2018-23-4-195-200 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Зиновьева ОЕ, Катушкина ЭА, Мозолевский ЮВ и др. Синдром ригидного человека: вопросы патогенеза и лечения. Неврологический журнал. 2009;14(1):11-7.</mixed-citation><mixed-citation xml:lang="en">Zinov'eva OE, Katushkina JeA, Mozolevskij YuV, et al. Stiff-man syndrome: the aspects regarding its pathogenesis and treatment. Nevrologicheskii zhurnal. 2009;14(1):11-7 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Яхно НН, Голубева ВВ, Мозолевский ЮВ и др. Синдром ригидного человека с глазодвигательными и мозжечковыми нарушениями. Анналы клинической и экспериментальной неврологии. 2007;1(4):15-22.</mixed-citation><mixed-citation xml:lang="en">Yakhno NN, Golubeva VV, Mozolevskij YuV, et al. Stiff-person syndrome with oculomotor and cerebellar disturbances. Annaly klinicheskoy i experimental'noy nevrologii. 2007;1(4):15-22 (In Russ.).</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Matsumoto S, Kusuhara T, Nakajima, et al. Acute attacks and brain stem signs in a patient with glutamic acid decarboxylase autoantibodies. J Neurol Neurosurg Psychiatry. 2002 Sep;73(3):345-6. doi: 10.1136/jnnp.73.3.345</mixed-citation><mixed-citation xml:lang="en">Matsumoto S, Kusuhara T, Nakajima, et al. Acute attacks and brain stem signs in a patient with glutamic acid decarboxylase autoantibodies. J Neurol Neurosurg Psychiatry. 2002 Sep;73(3):345-6. doi: 10.1136/jnnp.73.3.345</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Munoz-Lopetegi A, de Bruijn MAAM, Boukhrissi S, et al. Neurologic syndromes related to anti-GAD65: Clinical and serologic response to treatment. Neurol Neuroimmunol Neuroinflamm. 2020;7(3):e696. doi: 10.1212/NXI.0000000000000696</mixed-citation><mixed-citation xml:lang="en">Munoz-Lopetegi A, de Bruijn MAAM, Boukhrissi S, et al. Neurologic syndromes related to anti-GAD65: Clinical and serologic response to treatment. Neurol Neuroimmunol Neuroinflamm. 2020;7(3):e696. doi: 10.1212/NXI.0000000000000696</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Hadjivassiliou M, Aeschlimann D, Grunewald RA, et al. GAD antibody associated neurological illness and its relationship to gluten sensitivity. Acta Neurol Scand. 2011 Mar;123(3):175-80. doi: 10.1111/j.1600-0404.2010.01356.x</mixed-citation><mixed-citation xml:lang="en">Hadjivassiliou M, Aeschlimann D, Grunewald RA, et al. GAD antibody associated neurological illness and its relationship to gluten sensitivity. Acta Neurol Scand. 2011 Mar;123(3):175-80. doi: 10.1111/j.1600-0404.2010.01356.x</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Nanri K, Okuma M, Sato S, et al. Prevalence of autoantibodies and the efficacy of immunotherapy for autoimmune cerebellar ataxia. Intern Med. 2016;55(5):449-54. doi: 10.2169/internalmedicine.55.5156. Epub 2016 Mar 1.</mixed-citation><mixed-citation xml:lang="en">Nanri K, Okuma M, Sato S, et al. Prevalence of autoantibodies and the efficacy of immunotherapy for autoimmune cerebellar ataxia. Intern Med. 2016;55(5):449-54. doi: 10.2169/internalmedicine.55.5156. Epub 2016 Mar 1.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Wiels W, Guisset F, Vandervorst F, et al. Rapidly progressive cerebellar hemiataxia with high levels of GAD65 reactive antibodies. Mov Disord Clin Pract. 2017 Jun 1;4(4):632-4. doi: 10.1002/mdc3.12504. eCollection Jul-Aug 2017.</mixed-citation><mixed-citation xml:lang="en">Wiels W, Guisset F, Vandervorst F, et al. Rapidly progressive cerebellar hemiataxia with high levels of GAD65 reactive antibodies. Mov Disord Clin Pract. 2017 Jun 1;4(4):632-4. doi: 10.1002/mdc3.12504. eCollection Jul-Aug 2017.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Awad A, Stuve O, Mayo M, et al. Anti-glutamic acid decarboxylase antibody-associated ataxia as an extrahepatic autoimmune manifestation of hepatitis C infection: a case report. Case Rep Neurol Med. 2011;2011:975152. doi: 10.1155/2011/975152. Epub 2011 Jul 10.</mixed-citation><mixed-citation xml:lang="en">Awad A, Stuve O, Mayo M, et al. Anti-glutamic acid decarboxylase antibody-associated ataxia as an extrahepatic autoimmune manifestation of hepatitis C infection: a case report. Case Rep Neurol Med. 2011;2011:975152. doi: 10.1155/2011/975152. Epub 2011 Jul 10.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Navarta LM, Espul CA, Acosta-Rivero N. High prevalence of a variety of autoantibodies in a population of hepatitis C virus-infected individuals. APMIS. 2018 Jun;126(6):515-22. doi: 10.1111/apm.12850</mixed-citation><mixed-citation xml:lang="en">Navarta LM, Espul CA, Acosta-Rivero N. High prevalence of a variety of autoantibodies in a population of hepatitis C virus-infected individuals. APMIS. 2018 Jun;126(6):515-22. doi: 10.1111/apm.12850</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Fujioka T, Honda M, Yoshizaki T, et al. A case of type 1 diabetes onset and recurrence of Graves' disease during pegylated interferon-α plus ribavirin treatment for chronic hepatitis C. Intern Med. 2010;49(18):1987-90. doi: 10.2169/internalmedicine.49.3831. Epub 2010 Sep 15.</mixed-citation><mixed-citation xml:lang="en">Fujioka T, Honda M, Yoshizaki T, et al. A case of type 1 diabetes onset and recurrence of Graves' disease during pegylated interferon-α plus ribavirin treatment for chronic hepatitis C. Intern Med. 2010;49(18):1987-90. doi: 10.2169/internalmedicine.49.3831. Epub 2010 Sep 15.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Shiba T, Morino Y, Tagawa K, et al. Onset of diabetes with high titer anti-GAD antibody after IFN therapy for chronic hepatitis. Diabetes Res Clin Pract. 1995 Dec;30(3):237-41. doi: 10.1016/0168-8227(95)01188-9</mixed-citation><mixed-citation xml:lang="en">Shiba T, Morino Y, Tagawa K, et al. Onset of diabetes with high titer anti-GAD antibody after IFN therapy for chronic hepatitis. Diabetes Res Clin Pract. 1995 Dec;30(3):237-41. doi: 10.1016/0168-8227(95)01188-9</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Baizabal-Carvallo JF, Alonso-Juarez M. Vertical nystagmus associated with glutamic acid decarboxylase antibodies responding to cyclophosphamide. J Neuroimmunol. 2018 Apr 15;317:5-7. doi: 10.1016/j.jneuroim.2018.01.013. Epub 2018 Feb 3.</mixed-citation><mixed-citation xml:lang="en">Baizabal-Carvallo JF, Alonso-Juarez M. Vertical nystagmus associated with glutamic acid decarboxylase antibodies responding to cyclophosphamide. J Neuroimmunol. 2018 Apr 15;317:5-7. doi: 10.1016/j.jneuroim.2018.01.013. Epub 2018 Feb 3.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
