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BMC Neurology

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Open Access 01-12-2011 | Case report

Cognitive decline in a patient with anti-glutamic acid decarboxylase autoimmunity; case report

Authors: Masahito Takagi, Hiroshi Yamasaki, Keiko Endo, Tetsuya Yamada, Keizo Kaneko, Yoshitomo Oka, Etsuro Mori

Published in: BMC Neurology | Issue 1/2011

Abstract

Background

Glutamic acid decarboxylase (GAD) is the rate-limiting enzyme for producing γ-aminobutyric acid, and it has been suggested that antibodies against GAD play a role in neurological conditions and type 1 diabetes. However, it is not known whether dementia appears as the sole neurological manifestation associated with anti-GAD antibodies in the central nervous system.

Case presentation

We describe the clinical, neuropsychological, and neuroradiological findings of a 73-year-old female with cognitive dysfunction and type 1A diabetes. Observation and neuropsychological studies revealed linguistic problems, short-term memory disturbance, and frontal dysfunction. MRI showed no significant lesion except for confluent small T2-hyperintensity areas localized in the left basal ganglia. ¹⁸F-fluorodeoxy glucose-positron emission tomography (FDG-PET) and ¹²³I-N-isopropyl-p-iodoamphetamine-single photon emission computed tomography (IMP-SPECT) studies showed bifrontal hypometabolism and hypoperfusion. Immunomodulating therapy with intravenous high-dose immunoglobulin resulted in no remission of the cognitive symptoms.

Conclusions

Cognitive dysfunction may develop as an isolated neurological manifestation in association with type 1A diabetes and anti-GAD autoimmunity. A systematic study with extensive neuropsychological assessment is indicated in patients with type 1 diabetes and anti-GAD autoimmunity.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2377/11/156/prepub

Title: Cognitive decline in a patient with anti-glutamic acid decarboxylase autoimmunity; case report
Authors: Masahito Takagi
Hiroshi Yamasaki
Keiko Endo
Tetsuya Yamada
Keizo Kaneko
Yoshitomo Oka
Etsuro Mori
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/1471-2377-11-156

At a glance: The STEP trials

Springer Medicine

Cognitive decline in a patient with anti-glutamic acid decarboxylase autoimmunity; case report

Abstract

Background

Case presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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