High Titer of Circulating Antiglutamic Acid Decarboxylase Antibodies in a Patient with Cerebellar Ataxia and Type 1 Diabetes.

Q4 Medicine

Connecticut Medicine Pub Date : 2017-03-01

Rachna Kataria, Sushmitha Fernandes, Jasmin Lebastchi, Claudio A Bravo, Kanaga N Sena

{"title":"High Titer of Circulating Antiglutamic Acid Decarboxylase Antibodies in a Patient with Cerebellar Ataxia and Type 1 Diabetes.","authors":"Rachna Kataria, Sushmitha Fernandes, Jasmin Lebastchi, Claudio A Bravo, Kanaga N Sena","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>A 24-year-old female who was recently diagnosed with Type 1 diabetes mellitus (TiD) presented with a five-year history of visible gait disturbance and slurred speech. Her neurologic examination was remarkable for dysarthria, bilateral nystagmus, dysdiadochokinesia, finger-nose incoordination, heel-knee incoordination, and ataxic gait. A brain MRI disclosed diffuse cerebellar atrophy. Her serum antiglutamic acid decarboxylase (GAD) antibody titer was elevated. Antinuclear antibody (ANA) test was positive with atiterofl:2560 and a speckledpattern. Genetictests for inherited ataxia, including Friedreich ataxia, were negative for mutations. Her cerebrospinal fluid (CSF) analysis revealed oligoclonal bands and she had a positive CSF GAD65 antibody. A diag- nosis of GAD antibody-induced cerebellar ataxia was considered. She developed GAD autoimmune antibody positive TiD during the course ofher dis- ease. GAD antibody-associated cerebellar ataxia is a rare entity, however it should be considered as a possibility in patients with associated autoimmune disease and positive anti-GAD antibody.</p>","PeriodicalId":35577,"journal":{"name":"Connecticut Medicine","volume":"81 3","pages":"161-164"},"PeriodicalIF":0.0000,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Connecticut Medicine","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

A 24-year-old female who was recently diagnosed with Type 1 diabetes mellitus (TiD) presented with a five-year history of visible gait disturbance and slurred speech. Her neurologic examination was remarkable for dysarthria, bilateral nystagmus, dysdiadochokinesia, finger-nose incoordination, heel-knee incoordination, and ataxic gait. A brain MRI disclosed diffuse cerebellar atrophy. Her serum antiglutamic acid decarboxylase (GAD) antibody titer was elevated. Antinuclear antibody (ANA) test was positive with atiterofl:2560 and a speckledpattern. Genetictests for inherited ataxia, including Friedreich ataxia, were negative for mutations. Her cerebrospinal fluid (CSF) analysis revealed oligoclonal bands and she had a positive CSF GAD65 antibody. A diag- nosis of GAD antibody-induced cerebellar ataxia was considered. She developed GAD autoimmune antibody positive TiD during the course ofher dis- ease. GAD antibody-associated cerebellar ataxia is a rare entity, however it should be considered as a possibility in patients with associated autoimmune disease and positive anti-GAD antibody.

本刊更多论文

1例小脑性共济失调合并1型糖尿病患者循环抗谷氨酸脱羧酶抗体的高滴度检测。

一位24岁的女性，最近被诊断为1型糖尿病(TiD)，表现为5年的明显步态障碍和言语不清。她的神经系统检查有明显的构音障碍、双侧眼球震颤、运动障碍、手指-鼻子不协调、脚跟-膝盖不协调和步态共济失调。脑部MRI显示弥漫性小脑萎缩。血清抗谷氨酸脱羧酶(GAD)抗体滴度升高。抗核抗体(ANA)试验阳性，atiterofl:2560，呈斑点状。遗传性共济失调的基因测试，包括弗里德里希共济失调，对突变呈阴性。她的脑脊液(CSF)分析显示寡克隆带，脑脊液GAD65抗体阳性。考虑诊断GAD抗体引起的小脑性共济失调。她在其他疾病期间出现广泛性焦虑症自身免疫抗体阳性TiD。GAD抗体相关的小脑性共济失调是一种罕见的实体，但在相关自身免疫性疾病和抗GAD抗体阳性的患者中应考虑其可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Connecticut Medicine Medicine-Medicine (all)

自引率

0.00%

发文量

期刊介绍： The Connecticut State Medical Society (CSMS) is a federation of eight component county medical associations, with a total membership exceeding 7,000 physicians. CSMS itself is a constituent state entity of the American Medical Association. Founded by the physician-patriots of the American Revolution, the Society operates from a heritage of democratic principles embodied in its Charter and Bylaws. The base of all authority in CSMS is, of course, the individual physician member. It is the decisions of members in their own county associations that ultimately determine the nature of the Society"s policies and activities.