Successful treatment with rituximab in a patient with stiff-person syndrome complicated by dysthyroid ophthalmopathy

Intern Med. 2010;49(3):237-41. doi: 10.2169/internalmedicine.49.2821. Epub 2010 Feb 1.


We report a patient with stiff-person syndrome and insulin-dependent diabetes mellitus with anti-glutamic acid decarboxylase (GAD) antibody, who suddenly complained of diplopia due to dysthyroid ophthalmopathy. Therapeutic efficacy of plasmapheresis and high-dose intravenous immunoglobulin was transient. After starting administration of rituximab, the patient showed obvious improvement of muscle spasms due to stiff-person syndrome and ophthalmoplegia following quick depletion of CD20-positive cells in peripheral blood. The anti-GAD and anti-thyroid antibodies decreased slowly. This drug might be a potent therapeutic option for refractory patients with stiff-person syndrome, particularly in those associated with dysthyroid ophthalmopathy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Autoantibodies
  • Biological Factors / therapeutic use*
  • Diabetes Mellitus, Type 1 / complications
  • Female
  • Glutamate Decarboxylase / immunology
  • Graves Ophthalmopathy / complications*
  • Humans
  • Middle Aged
  • Rituximab
  • Stiff-Person Syndrome / complications*
  • Stiff-Person Syndrome / drug therapy*


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Autoantibodies
  • Biological Factors
  • Rituximab
  • Glutamate Decarboxylase