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Predictive value of high titer of GAD65 antibodies in a case of limbic encephalitis
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 respective...
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Published in: | Journal of neuroimmunology 2019-12, Vol.337, p.577063-577063, Article 577063 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | 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.
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•Clinical spectrum of anti-GAD65 antibodies extended from asymptomatic to fulminant encephalitis.•Pathogenic link between the antibodies and limbic encephalitis appeared not clear•Antibodies titers may not be an indicator to guide long-term immunotherapy.•Narrow clinical and laboratory follow-up was relevant to therapeutic management.•Early treatment enabled good outcome in otherwise hard-to-treat condition. |
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ISSN: | 0165-5728 1872-8421 |
DOI: | 10.1016/j.jneuroim.2019.577063 |