Successful treatment with rituximab in a patient with stiff-person syndrome complicated by dysthyroid ophthalmopathy.
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.
Katoh
Nagaaki
N
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto.
Matsuda
Masayuki
M
Ishii
Wataru
W
Morita
Hiroshi
H
Ikeda
Shu-ichi
S
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*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D001685:Biological Factors; D000069283:Rituximab; D005968:Glutamate Decarboxylase