OBJECTIVE To explore the diversity and clinical features of anti-glutamate decarboxylase (GAD) antibody-associated neurological diseases. METHODS Clinical data of a series of 5 patients positive for anti-GAD antibodies were retrospectively analyzed. RESULTS All 5 patients were female, with a median age of 41.5 years (range 19-60 years). Their neurological symptoms included stiff-person syndrome (SPS), encephalitis, myelitis, cramp, visual loss, and paresthesia. Three patients (60%) were diagnosed with tumors, 2 cases of thymic tumor and 1 of breast cancer. On immunohistochemistry for tumor pathology, expression of GAD65 was found only in 1 patient. Four patients (80%) had abnormal brain MRI findings. All patients received immunotherapy and improved significantly after treatment, but 4 (80%) then experienced a relapse. CONCLUSIONS Neurological manifestations in anti-GAD-positive patients are diverse and include SPS, encephalitis, myelitis, cramp, visual loss, and paresthesia.

中文翻译：

---

谷氨酸脱羧酶抗体患者的临床异质性。

目的探讨抗谷氨酸脱羧酶（GAD）抗体相关的神经系统疾病的多样性和临床特征。方法回顾性分析5例抗GAD抗体阳性的患者的临床资料。结果所有5例患者均为女性，中位年龄为41.5岁（范围19-60岁）。他们的神经系统症状包括僵人综合征（SPS），脑炎，脊髓炎，抽筋，视力减退和感觉异常。3例（60％）被诊断出患有肿瘤，2例胸腺肿瘤和1例乳腺癌。在用于肿瘤病理学的免疫组织化学中，仅在1名患者中发现了GAD65的表达。四名患者（80％）的脑部MRI检查结果异常。所有患者均接受了免疫治疗，治疗后明显好转，但有4名患者（80％）随后复发。