Immunotherapy-responsive Non-paraneoplastic Encephalitis with Antibodies against GAD, LGI1, and GABA<sub>A</sub> Receptor
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- Nakano Takahiro
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Chihara Norio
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Matoba Kento
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Tachibana Hisatsugu
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Okuda Shiho
- Department of Neurology, Hyogo Rehabilitation Center Hospital, Japan
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- Otsuka Yoshihisa
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Ueda Takehiro
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Sekiguchi Kenji
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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- Kowa Hisatomo
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan
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- Leypoldt Frank
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Germany
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- Wandinger Klaus-Peter
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Germany
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- Matsumoto Riki
- Division of Neurology, Kobe University Graduate School of Medicine, Japan
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Abstract
<p>A 62-year-old man showed abnormal behavior. Brain magnetic resonance imaging revealed multifocal lesions on T2-weighted images. Initial screening revealed that he was seropositive for antibodies against glutamate decarboxylase, which usually indicates treatment resistance to autoimmune encephalitis (AE). Intensive immunosuppressive therapies, however, improved the neurological symptoms. In line with this, we also detected seropositivity for antibodies against leucine-rich glioma-inactivated 1 and gamma-aminobutyric acid A receptor (GABAAR). Brain imaging and treatment responsiveness suggested that antibodies against GABAAR were the main cause of symptoms. Furthermore, the patient showed the presence of triple anti-neural antibodies in the absence of malignancy and had a favorable clinical course. </p>
Journal
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- Internal Medicine
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Internal Medicine 61 (3), 419-423, 2022-02-01
The Japanese Society of Internal Medicine