We report the case of a 42-year-old woman who presented with vertigo and migraine and rapidly developed cognitive decline and seizures. Both serum and cerebro-spinal fluid samples showed high titer of anti-glutamic acid decarboxylase (anti-GAD65) antibodies (998,881 IU/ml and 54,687 IU/ml respectively). Limbic encephalitis was diagnosed and high dose steroids treatment started. During one-year follow-up, without further immunomodulatory therapy, the patient became seizure free, and cognitive functions returned to normal. Serum anti-GAD65 antibodies titer decreased significantly but remained elevated (192,680 IU/ml). We discuss the prognostic and pathogenic value of high titer anti-GAD65 antibodies and its variations in a case of autoimmune limbic encephalitis.

Predictive value of high titer of GAD65 antibodies in a case of limbic encephalitis / R. Di Giacomo, F. Deleo, C. Pastori, G. Didato, F. Andreetta, A. Del Sole, M. de Curtis, F. Villani. - In: JOURNAL OF NEUROIMMUNOLOGY. - ISSN 0165-5728. - 337(2019 Dec 15), pp. 577063.1-577063.4. [10.1016/j.jneuroim.2019.577063]

Predictive value of high titer of GAD65 antibodies in a case of limbic encephalitis

A. Del Sole;
2019

Abstract

We report the case of a 42-year-old woman who presented with vertigo and migraine and rapidly developed cognitive decline and seizures. Both serum and cerebro-spinal fluid samples showed high titer of anti-glutamic acid decarboxylase (anti-GAD65) antibodies (998,881 IU/ml and 54,687 IU/ml respectively). Limbic encephalitis was diagnosed and high dose steroids treatment started. During one-year follow-up, without further immunomodulatory therapy, the patient became seizure free, and cognitive functions returned to normal. Serum anti-GAD65 antibodies titer decreased significantly but remained elevated (192,680 IU/ml). We discuss the prognostic and pathogenic value of high titer anti-GAD65 antibodies and its variations in a case of autoimmune limbic encephalitis.
anti-glutamic acid decarboxylase 65 antibody; autoimmune encephalitis; immunotherapy; limbic encephalitis; neuroimmunology
Settore MED/26 - Neurologia
Settore MED/36 - Diagnostica per Immagini e Radioterapia
15-dic-2019
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/676087
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