Stiff-person syndrome following West Nile fever.
BACKGROUND
Stiff-person syndrome is a rare autoimmune disorder associated with antibodies against glutamic acid decarboxylase (GAD), the key enzyme in gamma-aminobutyric acid synthesis. In most cases, a trigger cannot be identified.


OBJECTIVE
To describe a 41-year-old man who developed stiff-person syndrome and antibodies to GAD following acute West Nile virus infection.


METHODS
A case report and a search in GenBank for common epitopes.


RESULTS
The search revealed a stretch of 12 amino acids in the NS1 protein of West Nile virus with a high degree of homology to the GAD65 region (an isoform of GAD) containing the PEVKEK motif.


CONCLUSIONS
Cross-reactivity between antibodies directed against West Nile virus and GAD may have contributed to the development of stiff-person syndrome in this patient.
Hassin-Baer
Sharon
S
Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Israel. shassin@post.tau.ac.il
Kirson
Eilon D
ED
Shulman
Lester
L
Buchman
Aron S
AS
Bin
Hanna
H
Hindiyeh
Musa
M
Markevich
Lea
L
Mendelson
Ella
E
D000328:Adult; D000595:Amino Acid Sequence; D001323:Autoantibodies / Q000097:blood; D005968:Glutamate Decarboxylase / Q000737:chemistry / Q000276:immunology; D006801:Humans; D007527:Isoenzymes / Q000737:chemistry / Q000276:immunology; D008297:Male; D008969:Molecular Sequence Data; D017386:Sequence Homology, Amino Acid; D016750:Stiff-Person Syndrome / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D017361:Viral Nonstructural Proteins / Q000737:chemistry; D014901:West Nile Fever / Q000150:complications*; D014902:West Nile virus
D001323:Autoantibodies; D007527:Isoenzymes; C100315:NS1 protein, Flavivirus; D017361:Viral Nonstructural Proteins; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2