Autoimmune encephalitis in glial fibrillary acidic protein astrocytopathy.
| Autor: | Zhao CW; Harvard Medical School, Boston, Massachusetts, USA wzhao0@partners.org.; Neurology, Mass General Brigham Inc, Boston, Massachusetts, USA., Gheihman G; Harvard Medical School, Boston, Massachusetts, USA.; Neurology, Mass General Brigham Inc, Boston, Massachusetts, USA., Nigam M; Harvard Medical School, Boston, Massachusetts, USA.; Neurology, Mass General Brigham Inc, Boston, Massachusetts, USA., Manzano GS; Harvard Medical School, Boston, Massachusetts, USA.; Neurology, Mass General Brigham Inc, Boston, Massachusetts, USA. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2024 May 09; Vol. 17 (5). Date of Electronic Publication: 2024 May 09. |
| DOI: | 10.1136/bcr-2024-260628 |
| Abstrakt: | Autoimmune encephalitis due to glial fibrillar acidic protein (GFAP) astrocytopathy is a rare cause of subacute neuropsychiatric changes. In this case, a young patient presented with a viral prodrome and meningismus, followed by progressive encephalopathy and movement disorders over the span of 2 weeks. Due to his clinical trajectory, inflammatory cerebrospinal fluid (CSF) analysis, initial normal brain imaging and negative serum autoimmune encephalopathy panel, his initial diagnosis was presumed viral meningoencephalitis. The recurrence and progression of neuropsychiatric symptoms and myoclonus despite antiviral treatment prompted further investigation, inclusive of testing for CSF autoimmune encephalopathy autoantibodies, yielding a clinically meaningful, positive GFAP autoantibody. This case highlights the importance of appropriately testing both serum and CSF autoantibodies when an autoimmune encephalitic process is considered. Through this case, we review the clinical and radiographic manifestations of GFAP astrocytopathy, alongside notable pearls pertaining to this autoantibody syndrome and its management. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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