Abstract |
Glutamic acid decarboxylase (GAD) has been recently identified as a target of humoral autoimmunity in a small subgroup of patients with non- paraneoplastic limbic encephalitis (NPLE). We present a patient with NPLE and positive anti-GAD antibodies who showed significant improvement after long-term immunotherapy. A 48-year old female was admitted with a two-year history of anterograde amnesia and seizures. Brain MRI revealed bilateral lesions of medial temporal lobes. Screening for anti-neuronal antibodies showed high anti-GAD titers in both serum and cerebrospinal fluid (CSF) with strong evidence of intrathecal production. The patient received treatment with prednisolone and long-term plasma exchange. During a 12-month follow-up, she exhibited complete seizure remission and an improvement in memory and visuo-spatial skills. Anti-GAD antibodies may serve as a useful marker to identify a subset of NPLE patients that respond to immunoregulatory treatment.
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Authors | Ioannis Markakis, Harry Alexopoulos, Cornelia Poulopoulou, Sofia Akrivou, Athanasios Papathanasiou, Vassiliki Katsiva, Georgios Lyrakos, Georgios Gekas, Marinos C Dalakas |
Journal | Journal of the neurological sciences
(J Neurol Sci)
Vol. 343
Issue 1-2
Pg. 192-4
(Aug 15 2014)
ISSN: 1878-5883 [Electronic] Netherlands |
PMID | 24950904
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2014 Elsevier B.V. All rights reserved. |
Chemical References |
- Antibodies
- Aspartic Acid
- N-acetylaspartate
- Prednisolone
- Glutamate Decarboxylase
- Creatine
- Choline
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Topics |
- Antibodies
(blood, cerebrospinal fluid)
- Aspartic Acid
(analogs & derivatives, metabolism)
- Choline
- Cognition Disorders
(etiology, therapy)
- Creatine
- Female
- Glutamate Decarboxylase
(immunology)
- Humans
- Immunotherapy
(methods)
- Limbic Encephalitis
(blood, cerebrospinal fluid, complications, therapy)
- Magnetic Resonance Imaging
- Middle Aged
- Perceptual Disorders
(etiology, therapy)
- Plasma Exchange
(methods)
- Prednisolone
(therapeutic use)
- Visual Perception
(drug effects, physiology)
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