Endocrine Abstracts

Introduction: High levels of autoantibodies to glutamic acid decarboxylase (GAD-Ab) have been described in multiple conditions such as: stiff-man syndrome, type 1 diabetes mellitus, latent autoimmune diabetes in adults (LADA), patients with auto-immune polyglandular failure and etc. In addition, some of the patients with progressive cerebellar ataxia show high titer of GAD-Ab, it may play a critical role in its development, as these antibodies are involved in the pathogenesis suggesting its auto-immune origin. This is a case report of a patient presenting with cerebellar ataxia with new onset latent autoimmune diabetes in adults.

Case Report: A 32-year-old Georgian woman presented with polyuria, polydipsia and 8 kg weight loss for past 2 months. One year before presentation the patient was diagnosed with cerebellar ataxia and was currently disabled, using cane to walk. For two years before the diagnosis she had complained of progressive gait instability and at the diagnosis brain magnetic resonance imaging showed mild cerebellar atrophy. The patient examination revealed dysarthria, horizontal nystagmus, right side head deviation, motor deficiency in right upper and lower limbs, positive Romberg sign. Routine biochemical studies as well as an immunological screening were performed. The laboratory examination showed marked hyperglycemia, glucosuria, ketonuria and impaired insulin secretion. Farther examination showed high Anti-glutamic acid decarboxylase (GAD) antibodies in patient’s serum.

Conclusion: In this case cerebellar ataxia and latent autoimmune diabetes in adults can be related autoimmune conditions.