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Abstract
Autoimmune cerebellar ataxia related to GAD-ab is a rare condition that typically affects women with late-onset type 1 diabetes or other autoimmune disorders.1,2 Cerebellar ataxia, the second most common syndrome associated with high GAD-ab values, shares the same demographic, clinical, and immunological features with stiff person syndrome.3 The demonstration of an increased intrathecal synthesis of GAD-ab is important to confirm that the GAD autoimmunity is related to the neurological syndrome, especially when there is concomitant type 1 diabetes that could explain the presence of high GAD-ab.3 GAD-ab concentrations in patients with cerebellar ataxia and in patients with stiff person syndrome are substantially higher than values in those with a recent diagnosis of type 1 diabetes. The pathogenic role of autoimmunity and GAD-ab in cerebellar ataxia remains unclear but it seems that GAD-abs are directly responsible for the pathogenesis of the cerebellar ataxia.4 Our patient most likely has latent autoimmune diabetes of the adult.