Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia.
Neurol Sci. 2011 Oct;32(5):911-4. doi: 10.1007/s10072-011-0506-7. Epub 2011 Mar 10.
A 25-year-old female presented to a university neurology clinic with a 1-month history of progressive ataxia, downbeat nystagmus and spastic tetraparesis. Personal history revealed polyarthralgias and weight loss. Family history was negative. Following thorough history, laboratory, neurophysiological and MRI investigations, a diagnosis of cerebellar ataxia due to coeliac disease was done. The patient was treated with strict gluten-free diet and intravenous administration of immunoglobulins. Although there are many controversies about neurological manifestations of coeliac disease, this case pointed to strong association between these two disorders. The findings of elevated protein content in the cerebrospinal fluid with positive oligoclonal bands suggested an immune-mediated process, further supported by positive anti-endomysium antibodies and anti-transglutaminase antibodies in the cerebrospinal fluid.
一位 25 岁女性因进行性共济失调、下视性眼球震颤和痉挛性四肢瘫痪到一所大学神经科诊所就诊。个人病史显示多发性关节痛和体重减轻。家族病史阴性。经过详细的病史、实验室、神经生理学和 MRI 检查，诊断为乳糜泻引起的小脑共济失调。患者接受了严格的无麸质饮食和静脉注射免疫球蛋白治疗。尽管乳糜泻的神经表现存在许多争议，但本病例表明这两种疾病之间存在很强的关联。脑脊液中蛋白含量升高伴有寡克隆带阳性提示免疫介导的过程，脑脊液中抗肌内膜抗体和抗转谷氨酰胺酶抗体阳性进一步支持这一过程。
