A case report of autoimmune glial fibrillary acidic protein astrocytopathy combined with Epstein-Barr virus infection
Year: 2025
Type: article
Study design: Case Report
Abstract: BACKGROUND: This report provides a comprehensive overview of the clinical manifestations, diagnostic evaluations, treatment, and prognosis of a 36-year-old male patient diagnosed with autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) in conjunction with Epstein-Barr virus (EBV) infection at our institution. Reports of GFAP-A associated with viral infections are infrequent. CASE PRESENTATION: The patient exhibited a range of symptoms, including fever, gait instability resembling ataxia, a sensation akin to stepping on cotton, diminished responsiveness, cognitive decline, urinary and bowel dysfunction, and persistent hiccups. Enhanced imaging of the thoracic spine revealed patchy meningeal enhancement, with central canal-like enhancement observed in coronal views. Additionally, radiating perivascular linear enhancement was noted in the ventricular white matter, cerebellum, and other regions, alongside the aforementioned central canal-like enhancement. Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) confirmed the presence of human herpesvirus type 4 (EBV). Both cell-based assay (CBA) and tissue-based assay (TBA) tests validated the presence of GFAP antibodies in the CSF. Following treatment with acyclovir for antiviral therapy and high-dose corticosteroid therapy, the patient demonstrated significant clinical improvement. CONCLUSIONS: It is postulated that the viral infection may have precipitated autoimmune meningoencephalitis. Providing more related cases for the diagnosis of this disease.
Source: BMC Neurology
Authors: Qi An, Limei Liu
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W4413497970