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

Roberta Di Giacomo; Francesco Deleo; Chiara Pastori; Giuseppe Didato; Francesca Andreetta; Angelo Del Sole; Marco de Curtis; Flavio Villani

doi:10.1016/j.jneuroim.2019.577063

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

Roberta Di Giacomo, Francesco Deleo, Chiara Pastori, Giuseppe Didato, Francesca Andreetta, Angelo Del Sole, Marco de Curtis, Flavio Villani

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Article number	577063
Journal	Journal of Neuroimmunology
Volume	337
DOIs	https://doi.org/10.1016/j.jneuroim.2019.577063
Publication status	Published - Dec 15 2019

Keywords

Anti-glutamic acid decarboxylase 65 antibody
Autoimmune encephalitis
Immunotherapy
Limbic encephalitis
Neuroimmunology

ASJC Scopus subject areas

Immunology and Allergy
Immunology
Neurology
Clinical Neurology

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title = "Predictive value of high titer of GAD65 antibodies in a case of limbic encephalitis",

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.",

keywords = "Anti-glutamic acid decarboxylase 65 antibody, Autoimmune encephalitis, Immunotherapy, Limbic encephalitis, Neuroimmunology",

author = "{Di Giacomo}, Roberta and Francesco Deleo and Chiara Pastori and Giuseppe Didato and Francesca Andreetta and {Del Sole}, Angelo and {de Curtis}, Marco and Flavio Villani",

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doi = "10.1016/j.jneuroim.2019.577063",

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AU - Di Giacomo, Roberta

AU - Deleo, Francesco

AU - Pastori, Chiara

AU - Didato, Giuseppe

AU - Andreetta, Francesca

AU - Del Sole, Angelo

AU - de Curtis, Marco

AU - Villani, Flavio

PY - 2019/12/15

Y1 - 2019/12/15

N2 - 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.

AB - 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.

KW - Anti-glutamic acid decarboxylase 65 antibody

KW - Autoimmune encephalitis

KW - Immunotherapy

KW - Limbic encephalitis

KW - Neuroimmunology

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JO - Journal of Neuroimmunology

JF - Journal of Neuroimmunology

SN - 0165-5728

M1 - 577063

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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