title: Successful treatment with rituximab in a patient with stiff-person syndrome complicated by dysthyroid ophthalmopathy.
abstract: We report a patient with stiff-person syndrome and insulin-dependent diabetes mellitus with anti-glutamic acid decarboxylase (GAD) antibody, who suddenly complained of diplopia due to dysthyroid ophthalmopathy. Therapeutic efficacy of plasmapheresis and high-dose intravenous immunoglobulin was transient. After starting administration of rituximab, the patient showed obvious improvement of muscle spasms due to stiff-person syndrome and ophthalmoplegia following quick depletion of CD20-positive cells in peripheral blood. The anti-GAD and anti-thyroid antibodies decreased slowly. This drug might be a potent therapeutic option for refractory patients with stiff-person syndrome, particularly in those associated with dysthyroid ophthalmopathy.
authors.affiliation: Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto.
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Katoh
authors.forename: Masayuki
authors.initials: M
authors.lastname: Matsuda
authors.forename: Wataru
authors.initials: W
authors.lastname: Ishii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morita
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Ikeda
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D001685:Biological Factors / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D049970:Graves Ophthalmopathy / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D000069283:Rituximab; D016750:Stiff-Person Syndrome / Q000150:complications* / Q000188:drug therapy*
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D001685:Biological Factors; D000069283:Rituximab; D005968:Glutamate Decarboxylase