Neurologic disorders associated with anti-glutamic acid decarboxylase antibodies: A comparison of anti-GAD antibody titers and time-dependent changes between neurologic disease and type I diabetes mellitus

• Published in: Journal of neuroimmunology 2018-04, Vol.317, p.84-89
• Main Authors: Nakajima, Hideto, Nakamura, Yoshitsugu, Inaba, Yuiko, Tsutsumi, Chiharu, Unoda, Kiichi, Hosokawa, Takafumi, Kimura, Fumiharu, Hanafusa, Toshiaki, Date, Masamichi, Kitaoka, Haruko
• Format: Article
• Language: English
• Subjects: Anti-GAD antibody; Cerebellar ataxia; Neurologic disorders; Stiff person syndrome; Type I diabetes mellitus
• ISSN: 0165-5728; 1872-8421
• DOI: 10.1016/j.jneuroim.2018.01.007

To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis. Anti-GAD-Ab titers in T1DM decreased over time, whereas they remained high in neurologic disorders. Immunotherapy improved neurological disorders and anti-GAD-Ab titers and index provide clinically meaningful information about their diagnostic accuracy. [Display omitted] •Anti-GAD-Ab titers and changes were compared between neurologic disorders and T1DM.•High anti-GAD-Ab titers in neurologic disorders suggested intrathecal Ab synthesis.•Anti-GAD-Ab titers in T1DM dropped with time but stayed high in neurologic disorders.•Anti-GAD-Ab titers and index are useful for precise diagnosis of neurologic disorders.•Immunotherapy and checking neoplasms can help in management of neurologic disorders.