Work

Coexisting anti-NMDA and anti-GAD65 antibodies in a patient with autoimmune encephalitis: a case report

Year: 2026

Type: article

Abstract: Background Autoimmune encephalitis (AE) typically manifests with a wide range of neuropsychiatric symptoms. Although reports of overlapping antibodies in AE are increasing, their clinical significance remains incompletely understood. Coexisting antibodies may expand the phenotypic spectrum, make it difficult to attribute symptoms to a single disorder, and, in some cases, be associated with more complex disease courses and poorer outcomes. Case Presentation: A 56-year-old man with autoimmune encephalitis and overlapping anti-GAD65 and anti-NMDA antibodies is presented. His initial episodes of shouting and muscle contractions were misdiagnosed as psychogenic non-epileptic seizures. After progression to generalized tonic-clonic seizures and ICU admission, cerebrospinal fluid analysis confirmed the presence of both antibodies. Despite pulse methylprednisolone followed by plasmapheresis, his neurological status did not improve, and he died of septic shock. Conclusion Overlapping anti-NMDA and anti-GAD65 antibodies may predict a poorer prognosis and reduced immunotherapy response, necessitating early recognition and aggressive management.

Source: BMC Neurology

DOI: 10.1186/s12883-026-05559-0

Author: Tulay Guler

Institution: Sincan Training and Research Hospital

Language: English

Topic: Autoimmune Neurological Disorders and Treatments

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090