Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2009  |  Volume : 12  |  Issue : 1  |  Page : 40-44

An unusual cause of adult onset cerebellar ataxia with hypogonadism


Department of Neurology, BYL Nair Ch. Hospital and TN Medical College, Mumbai Central, Mumbai - 400008, Maharashtra, India

Correspondence Address:
Ramshekhar N Menon
Department of Neurology, BYL Nair Ch. Hospital and TN Medical College, Mumbai Central, Mumbai - 400 008, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.48852

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We report an unusual case of sporadic adult onset cerebellar ataxia with hypogonadism. A 40-year-old unmarried man presented with progressive ataxia and dysarthria along with complaints of non-development of secondary sexual characteristics and erectile dysfunction. There were complaints of intermittent diarrhea. Clinical examination revealed a pan-cerebellar syndrome with features of hypoandrogenism. No eye movement abnormalities were evident. There were signs of malabsorption. Investigations confirmed the presence of auto-antibodies found in celiac disease, and a duodenal biopsy confirmed the same. Hypoandrogenism was postulated to be due to hypergonadotropic hypogonadism which has been mentioned in a few patients of celiac disease. However, the pattern seen in our patient was of a hypogonadotropic hypogonadism. This is probably secondary to an autoimmune hypophysitis seen in some patients in the absence of other clinical manifestations. Autoantibody testing should be a diagnostic necessity in any adult with a sporadic cerebellar ataxia.


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