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<p>Central nervous system involvement in chronic graft-versus-host disease (CNS-cGVHD) is rare. This case report describes a young man who developed anti-glutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy after undergoing matched sibling donor hematopoietic stem cell transplantation. The therapeutic approach included intensive immunotherapy with methylprednisolone, immunoadsorption, Rituximab, and low-dose Daratumumab, in combination with four antiepileptic drugs and mycophenolate mofetil. This regimen led to a marked reduction in anti-GAD65 titers and an improvement in the NHS3 seizure severity score, decreasing from 8 to 3. Additionally, a review of the literature on post-transplant autoimmune encephalitis is also provided.</p>

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Case report: anti-GAD65 antibody-associated epilepsy as the primary manifestation of chronic graft-versus-host disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月30日

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  • Suge Yang,
  • Pengchen Gu,
  • Jingluan Tian,
  • Xiaowen Tang,
  • Qun Xue

摘要

Central nervous system involvement in chronic graft-versus-host disease (CNS-cGVHD) is rare. This case report describes a young man who developed anti-glutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy after undergoing matched sibling donor hematopoietic stem cell transplantation. The therapeutic approach included intensive immunotherapy with methylprednisolone, immunoadsorption, Rituximab, and low-dose Daratumumab, in combination with four antiepileptic drugs and mycophenolate mofetil. This regimen led to a marked reduction in anti-GAD65 titers and an improvement in the NHS3 seizure severity score, decreasing from 8 to 3. Additionally, a review of the literature on post-transplant autoimmune encephalitis is also provided.