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Autoimmune glial fibrillary acidic protein astrocytopathy mimicking acute ischemic stroke: a case report

Year: 2026

Type: article

Abstract: Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a recently identified autoimmune disorder of the central nervous system. It commonly manifests as meningitis, encephalitis, myelitis, or optic neuritis. However, presentations resembling stroke are exceedingly rare. Here, we report a case of autoimmune GFAP astrocytopathy initially misdiagnosed as acute ischemic stroke. The correct diagnosis was later established through the detection of GFAP antibodies in both the patient's serum and cerebrospinal fluid (CSF) using a cell-based assay (CBA). The patient initially responded to corticosteroid therapy; however, a relapse occurred during the tapering phase. After one year of treatment with oral prednisone and azathioprine, the patient achieved remission, with a subsequent negative result for GFAP antibodies. At the three-year follow-up, no recurrence was observed.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1768290

Authors: Xianfeng Hou, Xun Mo, Ting Chen, Kaibin Qin, Shanshan Yu

Institutions: Guiyang Medical University, Affiliated Hospital of Guizhou Medical University

Language: English

Topic: Autoimmune Neurological Disorders and Treatments

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801