- •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.
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)
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Published online: February 19, 2018
Accepted: February 13, 2018
Received in revised form: February 11, 2018
Received: December 26, 2017
© 2018 Elsevier B.V. All rights reserved.