Neurological Sciences

, Volume 34, Issue 10, pp 1847–1849 | Cite as

A complex case of anti-GAD antibody-related syndrome treated with Rituximab

  • D. BaronciniEmail author
  • F. Spagnolo
  • L. Sarro
  • G. Comi
  • M. A. Volonte’
Letter to the Editor

Dear Sirs

Glutamic acid decarboxylase (GAD) is involved in the metabolism of gamma aminobutyric acid (GABA). Anti-GAD antibodies (Ab) have been found in many neurological disorders [1], but also in autoimmune diseases such as type 1 diabetes mellitus, autoimmune thyroiditis and several other disorders associated under the autoimmune polyglandular syndrome-type 3 (APS-3) [1, 2].

We describe a patient suffering from a complex anti-GAD Ab-related syndrome who was consecutively treated with intravenous immunoglobulins and plasma exchange without lasting benefit. Therapy with Rituximab brought instead some sustained improvement.

Case report

A 44-year-old woman had two subsequent generalized epileptic seizures in June 1999. From the same year, she complained about tremors and muscles spasms in stressful conditions. Brain imaging and electroencephalographic (EEG) findings were normal. Treatment with sodium valproate was started, with complete control over the seizures. In October 2002, a...


Intravenous Immunoglobulin Cerebral Spinal Fluid Atrophic Gastritis Cerebellar Ataxia Sodium Valproate 
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The present work benefited from the neuropsychological assessment of Dr. Rosalinda Cardamone and Dr. Monica Falautano; we thank Dr. Vittorio Martinelli for the clinical supervision.

Conflict of interest

Prof. Comi has served on scientific advisory boards for Bayer Schering Pharma, Merck Serono, Teva Pharmaceutical Industries Ltd., sanofi-aventis, Novartis, and Biogen Idec; has received speaker honoraria from Teva Pharmaceutical Industries Ltd., Sanofi-Aventis, Serono Symposia International, Foundation, Biogen Idec, Merck Serono, Novartis, and Bayer Schering Pharma. Dr. Baroncini, Dr. Spagnolo, Dr. Sarro and Dr. Volontè report no disclosures and they did not receive any financial support and funding. All authors have read the manuscript, the paper has not been previously published and is not under simultaneous consideration by another journal. No ghost writing by authors not named on the list.

Supplementary material

Supplementary material 1 (MOV 4653 kb)


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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • D. Baroncini
    • 1
    Email author
  • F. Spagnolo
    • 1
  • L. Sarro
    • 1
  • G. Comi
    • 2
  • M. A. Volonte’
    • 1
  1. 1.Department of NeurologyINSPE, San Raffaele’s Scientific InstituteMilanItaly
  2. 2.Department of NeurologyINSPE, Vita-Salute San Raffaele UniversityMilanItaly

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