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Autoimmune GFAP astrocytopathy after viral encephalitis: A case report

  • Jie Li
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Yan Xu
    Correspondence
    Corresponding author.
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Haitao Ren
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Yicheng Zhu
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Bin Peng
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Liying Cui
    Affiliations
    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Neurosciences Center, Chinese Academy of Medical Sciences, Beijing, China
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Published:February 19, 2018DOI:https://doi.org/10.1016/j.msard.2018.02.020

      Highlights

      • Autoimmune GFAP astrocytopathy is a kind of novel meningoencephalomyelitis.
      • HSV infection may induce the autoimmune GFAP astrocytopathy.
      • Autoimmune GFAP astrocytopathy might be a new differential diagnosis for relapsing HSV encephalitis.

      Abstract

      Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a novel autoimmune disease. This is the first report of a case of autoimmune GFAP astrocytopathy after herpes simplex viral encephalitis (HSVE). A 35-year-old female patient presented with a combination of headache, fever, seizure and psychiatric/behavioral abnormalities. She had GFAP-IgG in both serum and cerebrospinal fluid (CSF). Magnetic resonance imaging (MRI) with gadolinium-enhancement revealed linear enhancement oriented radially to the ventricles. After treatment with corticosteroids, her symptoms were alleviated, the lesions enhancement reduced, and the immunoreactive intensity of GFAP-IgG decreased. This case shows an observational link between HSVE and autoimmune GFAP astrocytopathy, suggesting that autoimmune GFAP astrocytopathy may provide a new differential diagnosis for relapsing HSVE.

      Abbreviations:

      ANA (anti-nuclear antibodies), CMV (cytomegalovirus), CNS (central nervous system), CSF (cerebrospinal fluid), CT (computed tomography), ENA (anti-extractable nuclear antigen), GFAP (glial fibrillary acidic protein), HSV-1 (herpes simplex virus type 1), HSVE (herpes simplex viral encephalitis), IgG (immunoglobulin G), MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment), MRI (magnetic resonance imaging), NGS (next-generation sequencing), RA (rheumatoid arthritis), RV (rubella virus), SS (Sjogren's syndrome)

      Keywords

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