title: Stiff-person syndrome following West Nile fever.
abstract: 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.
authors.affiliation: Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Israel. shassin@post.tau.ac.il
authors.forename: Sharon
authors.initials: S
authors.lastname: Hassin-Baer
authors.forename: Eilon D
authors.initials: ED
authors.lastname: Kirson
authors.forename: Lester
authors.initials: L
authors.lastname: Shulman
authors.forename: Aron S
authors.initials: AS
authors.lastname: Buchman
authors.forename: Hanna
authors.initials: H
authors.lastname: Bin
authors.forename: Musa
authors.initials: M
authors.lastname: Hindiyeh
authors.forename: Lea
authors.initials: L
authors.lastname: Markevich
authors.forename: Ella
authors.initials: E
authors.lastname: Mendelson
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D007527:Isoenzymes; C100315:NS1 protein, Flavivirus; D017361:Viral Nonstructural Proteins; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2