Limbic encephalitis and type 1 diabetes with glutamic acid decarboxylase 65 (GAD65) autoimmunity: Improvement with high-dose intravenous immunoglobulin therapy - 04/07/12

Doi : 10.1016/j.diabet.2012.02.005

M. Lopez-Sublet ^a,^⁎ , H. Bihan ^b, G. Reach ^b, S. Dupont ^c, A. Didelot ^d, J.-J. Mourad ^a, A. Krivitzky ^a, R. Dhote ^a
^a Post-Emergency Unit, Department of Internal Medicine, Hôpital Avicenne, 125, route de Stalingrad, 93009 Bobigny cedex, France
^b Department of Endocrinology, Diabetes and Metabolic Diseases, Centre de Recherche en Nutrition Humaine, Avicenne Hospital, Assistance publique–Hôpitaux de Paris, University Paris-XIII, Bobigny, France
^c Department of Neurology, La Pitié-Salpetrière – Assistance publique–Hôpitaux de Paris, Pitié-Salpetrière, France
^d Department of Neurology, Neurological Hospital, Lyon, France

Corresponding author. Tel.: +33 1 48 95 53 90; fax: +33 1 48 95 53 99.

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Abstract

Glutamic acid decarboxylase antibodies (GAD-abs) are an immunological factor involved in type 1 diabetes and other diseases involving the central nervous system. This report is of a patient with type 1 diabetes and a rare case of non-paraneoplastic limbic encephalitis mediated by anti-GAD65 antibodies that improved with the use of immunosuppressive drugs.

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Résumé

Objectif

Les anticorps anti-acide glutamic decarboxylase 65 (ac anti-GAD) sont des facteurs immunologiques déterminants dans la physiopathologie du diabète de type 1 mais également dans un certain nombre de maladies du système nerveux central. Nous rapportons le cas d’une patiente avec un diabète de type 1 associé à une encéphalite limbique non paranéoplasique aux anticorps anti GAD, traitée par immunothérapie.

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Keywords : Type 1 diabetes, Glutamic acid decarboxylase 65 (GAD), Limbic encephalitis, Immunotherapy, Epilepsia

Mots clés : Diabète type 1, Acide glutamique décarboxylase 65 (GAD), Encéphalite limbique, Immunothérapie, Épilepsie

Abbreviations : GAD-abs, LE, CNS, GABA, SPS, VGKC, EEG, CPE, CSF, HbA_1c, IgIV, MRI

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Introduction

Case report

Diagnostic approach

Intravenous immunoglobulin treatment

Discussion

Conclusion

Disclosure of interest

Esportazione

Vol 38 - N° 3

P. 273-275 - giugno 2012 Ritorno al numero

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Limbic encephalitis and type 1 diabetes with glutamic acid decarboxylase 65 (GAD65) autoimmunity: Improvement with high-dose intravenous immunoglobulin therapy - 04/07/12

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