Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis
IntroductionAutoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a new form of autoimmunity-mediated central nervous system disease. It is especially easy to misdiagnose when clinical symptoms and cerebrospinal fluid (CSF) indicators are similar to those observed in patients with tube...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1123603/full |
| _version_ | 1811157731644538880 |
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| author | Ningxiang Qin Xingguo Wu Jing Wang Wei Wang Xuefeng Wang Yuanlin Ma Liang Wang |
| author_facet | Ningxiang Qin Xingguo Wu Jing Wang Wei Wang Xuefeng Wang Yuanlin Ma Liang Wang |
| author_sort | Ningxiang Qin |
| collection | DOAJ |
| description | IntroductionAutoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a new form of autoimmunity-mediated central nervous system disease. It is especially easy to misdiagnose when clinical symptoms and cerebrospinal fluid (CSF) indicators are similar to those observed in patients with tuberculous meningitis (TBM).MethodsWe retrospectively analyzed five cases of autoimmune GFAP astrocytopathy that were initially misdiagnosed as TBM.ResultsIn the five reported cases, all but one patient had meningoencephalitis in the clinic, and all patients exhibited increased pressure, lymphocytosis, increased protein levels, and decreased glucose levels in their CSF results and did not have typical imaging findings of autoimmune GFAP astrocytopathy. TBM was the initial diagnosis in all five patients. However, we found no direct evidence of tuberculosis infection, and anti-tuberculosis treatment had inconclusive effects. Following a GFAP antibody test, the diagnosis of autoimmune GFAP astrocytopathy was made.ConclusionWhen there is a suspected diagnosis of TBM but TB-related tests are negative, the possibility of autoimmune GFAP astrocytopathy should be considered. |
| first_indexed | 2024-04-10T05:12:17Z |
| format | Article |
| id | doaj.art-121fe46192b640d48f58af856dc21cbb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T05:12:17Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-121fe46192b640d48f58af856dc21cbb2023-03-09T06:29:39ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-03-011410.3389/fneur.2023.11236031123603Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitisNingxiang QinXingguo WuJing WangWei WangXuefeng WangYuanlin MaLiang WangIntroductionAutoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a new form of autoimmunity-mediated central nervous system disease. It is especially easy to misdiagnose when clinical symptoms and cerebrospinal fluid (CSF) indicators are similar to those observed in patients with tuberculous meningitis (TBM).MethodsWe retrospectively analyzed five cases of autoimmune GFAP astrocytopathy that were initially misdiagnosed as TBM.ResultsIn the five reported cases, all but one patient had meningoencephalitis in the clinic, and all patients exhibited increased pressure, lymphocytosis, increased protein levels, and decreased glucose levels in their CSF results and did not have typical imaging findings of autoimmune GFAP astrocytopathy. TBM was the initial diagnosis in all five patients. However, we found no direct evidence of tuberculosis infection, and anti-tuberculosis treatment had inconclusive effects. Following a GFAP antibody test, the diagnosis of autoimmune GFAP astrocytopathy was made.ConclusionWhen there is a suspected diagnosis of TBM but TB-related tests are negative, the possibility of autoimmune GFAP astrocytopathy should be considered.https://www.frontiersin.org/articles/10.3389/fneur.2023.1123603/fullautoimmune GFAP astrocytopathytuberculous meningitismeningoencephalitisanti-GFAP antibodycase report |
| spellingShingle | Ningxiang Qin Xingguo Wu Jing Wang Wei Wang Xuefeng Wang Yuanlin Ma Liang Wang Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis Frontiers in Neurology autoimmune GFAP astrocytopathy tuberculous meningitis meningoencephalitis anti-GFAP antibody case report |
| title | Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| title_full | Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| title_fullStr | Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| title_full_unstemmed | Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| title_short | Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| title_sort | case report autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis |
| topic | autoimmune GFAP astrocytopathy tuberculous meningitis meningoencephalitis anti-GFAP antibody case report |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1123603/full |
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