Coexistence of Anti-GAD and Anti-GABAAR Antibodies in an Autoimmune Encephalitis Patient: A Case Report.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

International Medical Case Reports Journal Pub Date : 2025-01-16 eCollection Date: 2025-01-01 DOI:10.2147/IMCRJ.S488194

Xiaoyan Lu, Hangfei Wu, Yuhao Tan, Xiaowei Mao

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Abstract

Background: Coexistence of autoimmune encephalitis (AE) with multiple autoantibodies is of particular concern because overlying antibodies may cause variation of clinical manifestations. Coexistence of anti-glutamic acid decarboxylase (GAD) and anti-Gamma-aminobutyric acid-α-receptor (GABAAR) antibodies in AE was rare.

Case presentation: A 44-year-old female patient presented to our hospital due to cognitive decline for 4 years, seizures, slowed speech and depression for 2 months. Based on her clinical manifestations and laboratory assessment results (positive anti-GAD and anti-GABAAR antibodies), she was diagnosed as AE with coexisting anti-GAD and anti-GABAAR antibodies. After treatment with intravenous methylprednisolone (at dose of 1000mg/d, 500mg/d, 250mg/d, 120mg/d, 80mg/d for 3 days respectively) and intravenous immunoglobulin (400 mg/kg/d for 5 days), her symptoms gradually improved with exception for the slowed speech. Oral prednisone acetate was continued after discharge, her symptoms of slowed speech improved at 6-month follow-up.

Conclusion: We report a case of AE co-existing with anti-GAD and anti-GABAAR antibodies, which has different characteristics from previous cases. Coexistence of neural auto-antibodies should be considered when patients suspected with autoimmune encephalitis.

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自身免疫性脑炎患者抗gad和抗gabaar抗体共存1例报告

背景：自身免疫性脑炎（AE）与多种自身抗体共存是一个特别值得关注的问题，因为覆盖的抗体可能导致临床表现的变化。抗谷氨酸脱羧酶（GAD）和抗γ -氨基丁酸-α-受体（GABAAR）抗体在AE中共存的情况很少见。病例介绍：一名44岁女性患者因认知能力下降4年，癫痫发作，言语迟缓，抑郁2个月来我院就诊。根据患者的临床表现和实验室评估结果（抗广泛性焦虑症和抗gabaar抗体阳性），诊断为AE，同时存在抗广泛性焦虑症和抗gabaar抗体。经甲泼尼龙静脉注射（剂量分别为1000mg/d、500mg/d、250mg/d、120mg/d、80mg/d，连续3天）和免疫球蛋白静脉注射（400mg /kg/d，连续5天），除言语迟缓外，症状逐渐好转。出院后继续口服醋酸泼尼松，随访6个月，言语迟缓症状有所改善。结论：我们报告了一例AE合并抗gad和抗gabaar抗体的病例，该病例具有不同于以往病例的特点。怀疑自身免疫性脑炎时应考虑神经自身抗体的共存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Medical Case Reports Journal MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

135

审稿时长

16 weeks

期刊介绍： International Medical Case Reports Journal is an international, peer-reviewed, open access, online journal publishing original case reports from all medical specialties. Submissions should not normally exceed 3,000 words or 4 published pages including figures, diagrams and references. As of 1st April 2019, the International Medical Case Reports Journal will no longer consider meta-analyses for publication.