GAD antibodies associated neurological disorders: incidence and phenotype distribution among neurological inflammatory diseases.
We investigated the prevalence and the clinical association of high titer of antibodies against glutamic acid decarboxylase (hGADAb) among unselected patients with inflammatory/autoimmune disorders of the nervous system. By indirect immunofluorescence examination of samples from 1435 patients, we identified 7 cases (0.48%) with hGADAb. Although stiff-person plus syndrome was the commonest clinical accompaniment, most of the patients presented with a combination of different symptoms, including psychiatric disturbances and intestinal motility disorders. Diagnosis delay and chronic evolution were common findings. In two cases persistently high values of hGADAb over the years were observed. The rarity and the phenotype heterogeneity of hGADAb clinical association should not discourage clinicians from antibody screening, at least in selected cases, as an early immunotherapy can change the otherwise chronic progression of this complex disorder spectrum.
Matà
Sabrina
S
Department of Neurological and Psychiatric Sciences, Azienda Ospedaliero-Universitaria di Careggi, Florence, Italy. masa@unifi.it
Muscas
Gian Carlo
GC
Cincotta
Massimo
M
Bartolozzi
Maria Letizia
ML
Ambrosini
Stefano
S
Sorbi
Sandro
S
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D020274:Autoimmune Diseases of the Nervous System / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D015994:Incidence; D007249:Inflammation / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D016750:Stiff-Person Syndrome / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D055815:Young Adult
D001323:Autoantibodies; D005968:Glutamate Decarboxylase