Τίτλος:
Immunotherapy-responsive limbic encephalitis with antibodies to glutamic acid decarboxylase
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Glutamic acid decarboxylase (GAD) has been recently identified as a target of humoral autoimmunity in a small subgroup of patients with non-paraneoplastic limbic encephalitis (NPLE). We present a patient with NPLE and positive anti-GAD antibodies who showed significant improvement after long-term immunotherapy. A 48-year old female was admitted with a two-year history of anterograde amnesia and seizures. Brain MRI revealed bilateral lesions of medial temporal lobes. Screening for anti-neuronal antibodies showed high anti-GAD titers in both serum and cerebrospinal fluid (CSF) with strong evidence of intrathecal production. The patient received treatment with prednisolone and long-term plasma exchange. During a 12-month follow-up, she exhibited complete seizure remission and an improvement in memory and visuo-spatial skills. Anti-GAD antibodies may serve as a useful marker to identify a subset of NPLE patients that respond to immunoregulatory treatment. © 2014 Elsevier B.V.
Συγγραφείς:
Markakis, I.
Alexopoulos, H.
Poulopoulou, C.
Akrivou, S.
Papathanasiou, A.
Katsiva, V.
Lyrakos, G.
Gekas, G.
Dalakas, M.C.
Περιοδικό:
Journal of the Neurological Sciences
Λέξεις-κλειδιά:
choline; etiracetam; glutamate decarboxylase antibody; immunoglobulin G antibody; inositol; methylprednisolone; n acetylaspartic acid; phenobarbital; phenytoin; prednisolone; antibody; aspartic acid; choline; creatine; glutamate decarboxylase; N-acetylaspartate; prednisolone, adult; agitation; anterograde amnesia; antibody blood level; antibody titer; anticonvulsant therapy; article; astrocytosis; brain biopsy; brain level; case report; cerebrospinal fluid level; confabulation; confusion; contrast enhancement; corticosteroid therapy; disease control; disorientation; drug dose reduction; female; follow up; glioma; hallucination; human; immunotherapy; long term care; middle aged; neuropsychological test; nuclear magnetic resonance imaging; paraneoplastic neuropathy; plasmapheresis; priority journal; proton nuclear magnetic resonance; remission; seizure; swelling; temporal lobe; tonic clonic seizure; analogs and derivatives; blood; cerebrospinal fluid; Cognition Disorders; complication; drug effects; immunology; immunotherapy; Limbic Encephalitis; metabolism; Perceptual Disorders; physiology; procedures; vision, Antibodies; Aspartic Acid; Choline; Cognition Disorders; Creatine; Female; Glutamate Decarboxylase; Humans; Immunotherapy; Limbic Encephalitis; Magnetic Resonance Imaging; Middle Aged; Perceptual Disorders; Plasma Exchange; Prednisolone; Visual Perception
DOI:
10.1016/j.jns.2014.05.032
