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Clinical Heterogeneity in Patients with Glutamate Decarboxylase Antibody
Jiehong Huang1,2,3, Huilu Li1,2,3, Ruisi Zhou1,2,3
1Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Objective:
To explore the diversity and clinical features of anti-glutamate decarboxylase (GAD) antibody-associated neurological diseases.
Methods:
Clinical data of a series of 5 patients positive for anti-GAD antibodies were retrospectively analyzed.
Results:
All 5 patients were female, with a median age of 41.5 years (range 19-60 years). Their neurological symptoms included stiff-person syndrome (SPS), encephalitis, myelitis, cramp, visual loss, and paresthesia. Three patients (60%) were diagnosed with tumors, 2 cases of thymic tumor and 1 of breast cancer. On immunohistochemistry for tumor pathology, expression of GAD65 was found only in 1 patient. Four patients (80%) had abnormal brain MRI findings. All patients received immunotherapy and improved significantly after treatment, but 4 (80%) then experienced a relapse.
Conclusions:
Neurological manifestations in anti-GAD-positive patients are diverse and include SPS, encephalitis, myelitis, cramp, visual loss, and paresthesia.
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