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2018 ; 13
(1
): 55
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
GAD65 autoantibody characteristics in patients with co-occurring type 1 diabetes
and epilepsy may help identify underlying epilepsy etiologies
#MMPMID29636076
Liimatainen S
; Honnorat J
; Pittock SJ
; McKeon A
; Manto M
; Radtke JR
; Hampe CS
Orphanet J Rare Dis
2018[Apr]; 13
(1
): 55
PMID29636076
show ga
BACKGROUND: Autoantibodies against the smaller isoform of glutamate decarboxylase
(GAD65Ab) reflect autoimmune etiologies in Type 1 diabetes (T1D) and several
neurological disorders, including Stiff Person Syndrome (SPS). GAD65Ab are also
reported in cases of epilepsy, indicating an autoimmune component. GAD65Ab in
patients with co-occurring T1D, epilepsy or SPS may be part of either autoimmune
pathogenesis. To dissect the etiologies associated with GAD65Ab, we analyzed
GAD65Ab titer, epitope specificity and enzyme inhibition in GAD65Ab-positive
patients diagnosed with epilepsy (n?=?28), patients with epilepsy and T1D
(n?=?10), patients with SPS (n?=?20), and patients with T1D (n?=?42). RESULTS:
GAD65Ab epitope pattern in epilepsy differed from T1D and SPS patients. Four of
10 patients with co-occurring T1D and epilepsy showed GAD65Ab profiles similar to
T1D patients, while lacking GAD65Ab characteristics found in GAD65Ab-positive
epilepsy patients. One of these patients responded well to anti-epileptic drugs
(AEDs), while another patient did not require medication for seizure control. The
third patient was refractory due to a diagnosis of meningioma. The response of
the remaining patient to AEDs was unknown. GAD65Ab in the remaining six patients
with T1D and epilepsy showed profiles similar to those in epilepsy patients.
CONCLUSIONS: Different autoimmune responses associated with T1D, epilepsy and SPS
are reflected by disease-specific GAD65Ab patterns. Moreover, the epileptic
etiology in patients diagnosed with both T1D and epilepsy may present two
different etiologies regarding their epileptic condition. In one group T1D
co-occurs with non-autoimmune epilepsy. In the other group GAD65Ab are part of an
autoimmune epileptic condition.