Stiff Person Syndrome

So I was perusing through some charts today when I came across an interesting problem list.

1.) HTN (high blood pressure)

2.) DM (diabetes mellitus)

3.) Stiff Person Syndrome

Whoa, stop there. With all the medical jargon physicians throw around, the best we could come up with is “Stiff Person” Syndrome? Seriously?

Come to find out, I had come across this condition when reading an article during my Internal Medicine rotation in January. It referred to a rare autoimmune condition where antibodies attack GAD (glutamic acid decarboxylase), the enzyme required to synthesize the primary inhibitory neurotransmitter in the central nervous system known as GABA. With these “anti-GAD antibodies”, less GABA is effectively made. Less GABA = less inhibition = net excitation. This excitation is manifested as “stiff”-ness the syndrome refers to. Come to find out, the mechanism behind Stiff Person Syndrome is the anti-GAD antibody.

What’s even more interesting is that these same antibodies have been shown to cross-react with pancreatic islet beta-cells (the cells which produce insulin). Destruction of said cells leads to type I diabetes… which also showed up in the aforementioned problem list.

So in conclusion, yes, Stiff Person Syndrome actually exists. Although it’s rare, one can’t dismiss the profound impact it has on the lives of patients who deal with the symptoms.

You can find more information about Stiff Person Syndrome and possible treatments here.

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