Glutamic Acid Decarboxylase Antibody in a Patient with Myelitis: A Retrospective Study
Glutamic Acid Decarboxylase Antibody in a Patient with Myelitis: A Retrospective Study
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DOI：
10.1159/000490530
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发表时间：
2018-01-01
影响因子：
2.4
通讯作者：
Gao, Cong
中科院分区：
文献类型：
--
作者：
Liu, Zifan;Huang, Qingmei;Gao, Cong
目的：评价脊髓炎患者血清谷氨酸脱羧酶（GAD）自身抗体的阳性率，描述GAD抗体阳性患者的临床表现。方法：收集390例脊髓炎患者血清标本，其中水通道蛋白4 （AQP4）抗体阳性210例，AQP4抗体阴性180例。间接免疫荧光法检测GAD65抗体。结果：390例患者血清和脑脊液抗体阳性1例（0.26%）。患者为女性，患有复发性脊髓炎和胸腺肿块。行胸腺切除术，病理检查显示为良性胸腺囊肿。CD3、CD4、CD8、CD20阳性淋巴细胞广泛浸润。免疫组化显示GAD65在囊肿中呈阳性表达。结论：尽管患者血清中存在GAD65抗体，但由于其罕见，不建议常规筛查脊髓炎患者的GAD65抗体。然而，对于诊断为癌症或胸腺异常的患者，应考虑筛查GAD65抗体。(C) 2018 S. Karger AG，巴塞尔
Objective: The aim of this study was to evaluate the positive rate of serum glutamic acid decarboxylase (GAD) autoantibody in patients with myelitis and to describe the clinical findings in patients with positive GAD antibody. Methods: Serum samples were collected from 390 patients with myelitis, including 210 patients positive for aquaporin 4 (AQP4) antibody and 180 patients negative for AQP4. GAD65 antibody was measured by an indirect immunofluorescence assay. Results: Only 1 serum and cerebral spinal fluid sample from 390 patients (0.26%) was positive for anti-GAD antibodies. The patient was a female with relapsing myelitis and a thymic mass. Thymic resection was undertaken, and pathological examination revealed a benign thymic cyst. Extensive infiltration of lymphocytes positive for CD3, CD4, CD8 and CD20 was found. Immunohistochemistry showed positive expression of GAD65 in the cyst. Conclusions: Although serum GAD65 antibodies were present in a patient, it is not recommended to routinely screen for GAD65 antibodies in patients with myelitis because of their rare occurrence. However, screening for GAD65 antibodies should be considered in patients who have been diagnosed with cancer or a thymic abnormality. (C) 2018 S. Karger AG, Basel