Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature
Glutamic acid decarboxylase (GAD) is an enzyme that catalyzes the conversion of glutamic acid into γ-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system (CNS). GAD is widely expressed in the CNS and pancreatic β-cells. GABA produced by GAD plays a role in...
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The Japan Endocrine Society
2025-03-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0457/_html/-char/en |
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| author | Shinichiro Sano Taemi Ogura Takayuki Takachi Yuki Murai Yasuko Fujisawa Tsutomu Ogata Kenichiro Watanabe Masaki Yoshimura |
| author_facet | Shinichiro Sano Taemi Ogura Takayuki Takachi Yuki Murai Yasuko Fujisawa Tsutomu Ogata Kenichiro Watanabe Masaki Yoshimura |
| author_sort | Shinichiro Sano |
| collection | DOAJ |
| description | Glutamic acid decarboxylase (GAD) is an enzyme that catalyzes the conversion of glutamic acid into γ-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system (CNS). GAD is widely expressed in the CNS and pancreatic β-cells. GABA produced by GAD plays a role in regulating insulin secretion in pancreatic islets. Anti-GAD antibody is an established marker of type 1 diabetes mellitus (T1DM) and is also associated with stiff-person syndrome (SPS) and several other neurological disorders, including ataxia, cognitive impairment, limbic encephalitis, and epilepsy, collectively referred to as GAD antibody-spectrum disorders (GAD-SD). We report the case of a 17-year-old male patient who developed GAD-SD and T1DM after allogeneic hematopoietic cell transplantation (HCT). He presented with memory disorders, including feelings of déjà vu, accompanied by vomiting and headaches, and exhibited abnormal brain magnetic resonance imaging and electroencephalogram results. In addition to elevated fasting plasma glucose and glycated hemoglobin levels, markedly elevated anti-GAD antibody levels were detected in the serum and cerebrospinal fluid. Based on these findings, the patient was diagnosed with GAD-SD and T1DM and treated with methylprednisolone, followed by multiple daily insulin injections. We also reviewed previously reported cases of GAD-SD following HCT and multiple positive islet-related antibodies. |
| format | Article |
| id | doaj-art-d2baf98b7e594b35a3d1d5aa114b88d5 |
| institution | OA Journals |
| issn | 1348-4540 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-d2baf98b7e594b35a3d1d5aa114b88d52025-08-20T02:18:04ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402025-03-0172333334010.1507/endocrj.EJ24-0457endocrjGlutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literatureShinichiro Sano0Taemi Ogura1Takayuki Takachi2Yuki Murai3Yasuko Fujisawa4Tsutomu Ogata5Kenichiro Watanabe6Masaki Yoshimura7Department of Diabetes and Metabolism, Shizuoka Children’s Hospital, Shizuoka 420-8660, JapanDepartment of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka 420-8660, JapanDepartment of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka 420-8660, JapanDepartment of Diabetes and Metabolism, Shizuoka Children’s Hospital, Shizuoka 420-8660, JapanDepartment of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu 431-3192, JapanDepartment of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu 431-3192, JapanDepartment of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka 420-8660, JapanDepartment of Epilepsy, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka 420-8688, JapanGlutamic acid decarboxylase (GAD) is an enzyme that catalyzes the conversion of glutamic acid into γ-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system (CNS). GAD is widely expressed in the CNS and pancreatic β-cells. GABA produced by GAD plays a role in regulating insulin secretion in pancreatic islets. Anti-GAD antibody is an established marker of type 1 diabetes mellitus (T1DM) and is also associated with stiff-person syndrome (SPS) and several other neurological disorders, including ataxia, cognitive impairment, limbic encephalitis, and epilepsy, collectively referred to as GAD antibody-spectrum disorders (GAD-SD). We report the case of a 17-year-old male patient who developed GAD-SD and T1DM after allogeneic hematopoietic cell transplantation (HCT). He presented with memory disorders, including feelings of déjà vu, accompanied by vomiting and headaches, and exhibited abnormal brain magnetic resonance imaging and electroencephalogram results. In addition to elevated fasting plasma glucose and glycated hemoglobin levels, markedly elevated anti-GAD antibody levels were detected in the serum and cerebrospinal fluid. Based on these findings, the patient was diagnosed with GAD-SD and T1DM and treated with methylprednisolone, followed by multiple daily insulin injections. We also reviewed previously reported cases of GAD-SD following HCT and multiple positive islet-related antibodies.https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0457/_html/-char/enanti-glutamic acid decarboxylase antibodyglutamic acid decarboxylase antibody-spectrum disordertype 1 diabetes mellitushematopoietic cell transplantation |
| spellingShingle | Shinichiro Sano Taemi Ogura Takayuki Takachi Yuki Murai Yasuko Fujisawa Tsutomu Ogata Kenichiro Watanabe Masaki Yoshimura Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature Endocrine Journal anti-glutamic acid decarboxylase antibody glutamic acid decarboxylase antibody-spectrum disorder type 1 diabetes mellitus hematopoietic cell transplantation |
| title | Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| title_full | Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| title_fullStr | Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| title_full_unstemmed | Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| title_short | Glutamic acid decarboxylase antibody-spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| title_sort | glutamic acid decarboxylase antibody spectrum disorders and type 1 diabetes mellitus in a patient following allogenic hematopoietic cell transplantation with review of literature |
| topic | anti-glutamic acid decarboxylase antibody glutamic acid decarboxylase antibody-spectrum disorder type 1 diabetes mellitus hematopoietic cell transplantation |
| url | https://www.jstage.jst.go.jp/article/endocrj/72/3/72_EJ24-0457/_html/-char/en |
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