Type 1 diabetes and GAD65 limbic encephalitis: a case report of a 10-year-old girl
-
Ema Grilo
,
Joana Pinto
Abstract
Limbic encephalitis is a rare neurological disorder that may be difficult to recognize. Clinical features include memory impairment, temporal lobe seizures and affective disturbance. We report the case of a 10-year-old girl with type 1 diabetes mellitus that presented with seizures, depressed mood and memory changes. The diagnosis of glutamic acid decarboxylase 65 (GAD65) mediated limbic encephalitis relied on cerebral magnetic resonance imaging lesions and high serological and cerebrospinal fluid GAD65-antibodies titers. High-dose steroidal therapy was started with clinical improvement. Relapse led to a second high-dose steroid treatment followed by rituximab with remission. A correlation between serum GAD65-antibodies levels and symptoms was found, demonstrating GAD65-antibodies titers may be useful for clinical follow-up and immunotherapy guidance. This report raises awareness of this serious neurological condition that may be associated with type 1 diabetes, underlining the importance of an early diagnosis and prompt treatment for a better prognosis.
Author contributions: The fist and corresponding author, Ema Grilo, is responsible for the first draft of the manuscript. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2016 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
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- Decreased undercarboxylated osteocalcin in children with type 2 diabetes mellitus
- Evaluation of left and right ventricular functions using conventional and tissue Doppler echocardiography in children with type 1 diabetes mellitus
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- Increased GLP-1 response to oral glucose in pre-pubertal obese children
- Prevalence of idiopathic intracranial hypertension and associated factors in obese children and adolescents
- Idiopathic postprandial hyperinsulinaemic hypoglycaemia
- Feeding, eating and behavioral disturbances in Prader-Willi syndrome and non-syndromal obesity
- Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study
- Ghrelin, insulin-like growth factor I and adipocytokines concentrations in born small for gestational age prepubertal children after the catch-up growth
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- Microarray analysis of slipped capital femoral epiphysis growth plates
- Case Reports
- Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of three cases from Iran
- Type 1 diabetes and GAD65 limbic encephalitis: a case report of a 10-year-old girl
- A novel splice site mutation in the GNPTAB gene in an Iranian patient with mucolipidosis II α/β
- Parent observed neuro-behavioral and pro-social improvements with oxytocin following surgical resection of craniopharyngioma
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Articles in the same Issue
- Frontmatter
- Original Articles
- Decreased undercarboxylated osteocalcin in children with type 2 diabetes mellitus
- Evaluation of left and right ventricular functions using conventional and tissue Doppler echocardiography in children with type 1 diabetes mellitus
- Prevalence of psychosocial morbidity in children with type 1 diabetes mellitus: a survey from Northern India
- Increased GLP-1 response to oral glucose in pre-pubertal obese children
- Prevalence of idiopathic intracranial hypertension and associated factors in obese children and adolescents
- Idiopathic postprandial hyperinsulinaemic hypoglycaemia
- Feeding, eating and behavioral disturbances in Prader-Willi syndrome and non-syndromal obesity
- Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study
- Ghrelin, insulin-like growth factor I and adipocytokines concentrations in born small for gestational age prepubertal children after the catch-up growth
- Zoledronate for Osteogenesis imperfecta: evaluation of safety profile in children
- Elevated serum adiponectin is related to elevated serum ferritin and interleukin-6 in β-thalassaemia major children
- GCK mutations in Chinese MODY2 patients: a family pedigree report and review of Chinese literature
- Cystinosis in Eastern Turkey
- Microarray analysis of slipped capital femoral epiphysis growth plates
- Case Reports
- Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy: report of three cases from Iran
- Type 1 diabetes and GAD65 limbic encephalitis: a case report of a 10-year-old girl
- A novel splice site mutation in the GNPTAB gene in an Iranian patient with mucolipidosis II α/β
- Parent observed neuro-behavioral and pro-social improvements with oxytocin following surgical resection of craniopharyngioma
- A fatal outcome of complicated severe diabetic ketoacidosis in a 11-year-old girl
