Glutamic Acid Decarboxylase Antibody in a Patient with Myelitis: A Retrospective Study

Liu, Zifan; Huang, Qingmei; Li, Huijuan; Qiu, Wei; Chen, Baikeng; Luo, Jie; Yang, Huiting; Liu, Tianni; Liu, Si; Xu, Huiming; Long, Youming; Gao, Cong

doi:10.1159/000490530

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…Interestingly, four patients developed relapses, including the patient with both thymic abnormalities. This situation suggests that patients with GAD65 antibodies, especially those with abnormal thymic glands, should be followed up regularly and receive immunotherapy [1,[8][9][10]. Our patient had abnormal cerebral and spinal MRI findings that entirely became normal within one month.…”

Section: Discussionmentioning

confidence: 73%

Untitled

2022

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Anti-GAD antibodies have been associated with numerous neurological conditions that have a wide variety of presentations. These conditions include limbic encephalitis, stiff person syndrome, opsoclonus-myoclonus-ataxia syndrome, cerebellar ataxia, and status epilepticus. In this paper, we aimed to present a female patient admitted with complaints of acute weakness and right peripheral facial palsy, pancytopenia, hepatosplenomegaly, and anti-glutamate decarboxylase antibody and report the diversity and clinical features of neurological diseases associated with anti-glutamate decarboxylase antibodies. ConclusionBesides the common primary syndromes, other new clinical and neurological manifestations have been associated with anti-anti-glutamate decarboxylase antibodies.

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Section: Discussionmentioning

confidence: 73%

Untitled

2022

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“…GAD-Abs are associated with multiple neurological syndromes, including SPS, cerebellar ataxia, nystagmus, palatal myoclonus and limbic encephalitis (5). These syndromes are considered to be caused by the decrease in GABA transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Stored at -80°C, serum and CSF samples were assessed for GAD65 antibody presence. The analysis was performed utilizing a commercial kit (Euroimmun, Luebeck, Germany) designed to assay anti-GAD65 antibody, which employs a GAD65-transfected cell line derived from human embryonic kidney 293 cells, as delineated previously (5).…”

Section: Anti-gad65 Antibody Assaymentioning

confidence: 99%

Case Report: Extraocular muscles paralysis associated with GAD65 antibody: a case series study

Zhang,

Yue,

Lian

et al. 2023

Front. Immunol.

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ObjectiveTo explore the clinical manifestations of glutamic acid decarboxylase 65 (GAD65) antibody-positive patients with extraocular symptoms and the possible mechanism.MethodAssays for the presence of GAD65 antibodies were performed on patients’ serum and cerebral spinal fluid (CSF). The brain and ocular structures involved in eye movement were assessed via magnetic resonance imaging (MRI). Tests such as electromyography (EMG), particularly repetitive nerve stimulation (RNS), and neostigmine tests were utilized for differential diagnosis. Additionally, the interaction of GAD65 antibodies with muscle tissue was confirmed using immunofluorescence techniques.ResultEach patient exhibited symptoms akin to extraocular myasthenia gravis (MG), with two individuals reporting diplopia and two experiencing ptosis. GAD65 antibodies were detected in either the serum or CSF, which were shown to bind with monkey cerebellum slides and mouse muscle slides. Neuroimaging of the brain and extraocular muscles via MRI showed no abnormalities, and all patients tested negative for the neostigmine test, RNS via EMG, and the presence of MG antibodies. However, thyroid-related antibodies were found to be abnormal in four of the patients.ConclusionOur results showed that GAD65 antibodies are not only associated with encephalitis, cerebellum ataxia or stiff-person syndrome caused by the decrease of GABAergic transmission but also diplopia and ptosis. Therefore, we should pay more attention to extraocular muscle paralysis patients without pathogenic antibodies directed against the components of neuromuscular junctions.

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“…Other autoantibodies that have been reported in association with myelitis include anti-glutamic acid decarboxylase (GAD), 80 antiglycine receptor in the context of progressive encephalomyelitis with rigidity and myoclonus, 81,82 and antiamphiphysin antibodies. 83,84…”

Section: Other Antibody-associated Autoimmune Diseasesmentioning

confidence: 99%

Immune-Mediated Myelopathies

Levy

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE Immune-mediated myelopathies are conditions in which the immune system attacks the spinal cord. This article describes the distinguishing characteristics of immune-mediated myelopathies and treatment strategies for patients affected by these disorders. LATEST DEVELOPMENTS New biomarkers, such as aquaporin 4 and myelin oligodendrocyte glycoprotein antibodies, in the blood and spinal fluid have led to the identification of antigen-specific immune-mediated myelopathies and approved therapies to prevent disease progression. ESSENTIAL POINTS The first step in the diagnosis of an immune-mediated myelopathy is confirming that the immune system is the cause of the attack by excluding non–immune-mediated causes. The second step is to narrow the differential diagnosis based on objective biomarkers such as serology and MRI patterns. The third step is to treat the specific immune-mediated myelopathy by using evidence-based medicine.

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Glutamic Acid Decarboxylase Antibody in a Patient with Myelitis: A Retrospective Study

Cited by 8 publications

References 12 publications

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Case Report: Extraocular muscles paralysis associated with GAD65 antibody: a case series study

Immune-Mediated Myelopathies

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