A new Purkinje cell antibody (anti-Ca) associated with subacute cerebellar ataxia: immunological characterization

Table 1 Laboratory findings, treatment, and treatment response over the course of disease

Months from onset	Cells/μl CSF	Total protein mg/dl	IgG anti-Ca titers (IHC)		QIgG anti-Ca	IgG total mg/dl		QIgG	IgM total mg/dl		QIgM	Albumin total mg/dl		QAlb	Qlim	AI anti-Ca	OCBs CSF/serum
			CSF	Serum		CSF	Serum		CSF	Serum		CSF	Serum
0	44 ↑	48 ↑	1:2000	1:6000	333.3	7.66	1190	6.44	0.567	267	2.12	25.1	3770	6.66	4.89	68.2	Pos/neg
Interventions:	3 × 1000 mg methylprednisolone (MP) intravenously followed by oral therapy over 3 weeks at an initial dose of 60 mg MP, resulting in marked neurological improvement. After tapering corticosteroids to 12.5 mg MP per day the patient experienced worsening of symptoms together with an exaggerated startle response (month 2).
2	1	31	N.d.	N.d.	N.d.	3	813	3.69	0.086	296	0.29	10.4	4410	2.36	1.46	N.d.	N.d.
Interventions:	5 × 500 mg methylprednisolone (MP) intravenously (month 3) and 5 × 500 mg methylprednisolone (MP) intravenously + intravenous immunoglobulins (month 4), followed by only slight and transient neurological improvement. Oral therapy with MP at an initial dose of 60 mg MP.
5	2	25	1:200	1:7000	28.6	1.9	927	2.05	0.065	251	0.26	14.7	3950	3.72	2.44	11.7	Pos/neg
Interventions:	Plasma exchange at month 6 (after progressive neurological deterioration), followed by clinical stabilization and moderate improvement.

AI = antibody index (see method section for details); CSF = cerebrospinal fluid; IHC = immunohistochemistry; QIgG = IgG CSF/serum ratio; QIgM = IgM CSF/serum ratio; QAlb = albumin CSF/serum ratio; Qlim = upper reference range for IgG, albumin-dependent (see method section for details); OCB = oligoclonal bands.

ISSN: 1742-2094