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Meningoencephalitis associated with GAD65 autoimmunity.
Zuying Kuang1, José Fidel Baizabal-Carvallo2,3, Mohammad Mofatteh4
1Department of Neurology, GuangDong 999 Brain Hospital, Guangzhou, China.
Frontiers in Immunology
|March 27, 2023
Summary
Meningoencephalitis is a rare presentation of glutamic acid decarboxylase 65 (GAD65) autoimmunity. Patients exhibit encephalitis symptoms with meningeal enhancement and respond well to immunotherapy, achieving good functional outcomes.
Area of Science:
- Neuroimmunology
- Neurology
Background:
- Autoimmunity targeting glutamic acid decarboxylase 65 (GAD65) is linked to encephalitis.
- Meningoencephalitis as a presentation of GAD65 autoimmunity is rarely documented.
Observation:
- Three male patients (16-36 years) presented with acute/subacute confusion, psychosis, cognitive decline, seizures, or tremor.
- No fever or meningeal irritation signs were observed; CSF showed mild pleocytosis or was normal.
- All patients received immunotherapy (corticosteroids or IVIg) with significant improvement.
Findings:
- Meningoencephalitis associated with GAD65 antibodies is uncommon.
- Patients presented with encephalitis symptoms and meningeal enhancement.
- All three identified patients achieved good functional outcomes (mRS ≤ 1) post-treatment.
Implications:
- Meningoencephalitis should be considered in autoimmune neurological disorders associated with GAD65 antibodies.
- Early immunotherapy can lead to favorable outcomes in GAD65-antibody-associated meningoencephalitis.
