Antinuclear antibodies and glutamic acid decarboxylase antibodies in children with refractory epilepsy

Abstract

BackgroundIncreased prevalence of antinuclear antibodies (ANA) and auto glutamic acid decarboxylase antibodies (GADA) ratio have been reported in patients with epilepsy. Anti-GAD antibodies (GADA) were first implicated in the pathogenesis of some neurological diseases including epilepsy. The aim of the studyTo determine the occurrence of GADA and ANA in the serum of children with refractory epilepsy. Patients and methodsForty children with refractory epilepsy 25 males and 15 females, mean age 9.17±3.4years were selected for this study. Patients with refractory epilepsy had recurrent seizures for more than 18months with no more than a 3-month seizure free period during those 18months and failure of at least two appropriate AEDs with proper doses, good compliance and within normal therapeutic range. Twenty children with controlled idiopathic epilepsy 15 males and 5 females newly diagnosed as suffering from various types of seizures generalized and partial types, mean age 10.1±3.1years were also included in this study. These children with idiopathic epilepsy were included in this study for comparison with children with refractory epilepsy as regard to the serum ANA and GADA. ResultsChildren with refractory epilepsy had high-serum levels of GADA and ANA in comparison to children with idiopathic epilepsy (P<0.001), also there was a significant correlation between the duration of seizures and the serum levels of ANA and GADA in children with refractory epilepsy. ConclusionChildren with refractory epilepsy had high-titer of GADA and ANA. The finding confirmed the association between high GADA, ANA and refractory epilepsy suggesting an immunologic origin of refractory epilepsy.