Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis
Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a treatable autoimmune disorder affecting the central nervous system. Despite extensive research, the exact etiology and pathogenesis of this condition remain unclear. In recent years, autoimmune encephalitis (AE) after viral enceph...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-09-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1258048/full |
| _version_ | 1797687148175949824 |
|---|---|
| author | Ping Cheng Ping Cheng Wenjuan Huang Meifang Yang Meifang Yang Zhiren Chen Zhiren Chen Yifan Geng Yifan Geng Xia Zhang Weiwei Chen Weiwei Chen |
| author_facet | Ping Cheng Ping Cheng Wenjuan Huang Meifang Yang Meifang Yang Zhiren Chen Zhiren Chen Yifan Geng Yifan Geng Xia Zhang Weiwei Chen Weiwei Chen |
| author_sort | Ping Cheng |
| collection | DOAJ |
| description | Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a treatable autoimmune disorder affecting the central nervous system. Despite extensive research, the exact etiology and pathogenesis of this condition remain unclear. In recent years, autoimmune encephalitis (AE) after viral encephalitis (VE) has gathered significant attention. Here, we present a case report of autoimmune GFAP astrocytopathy after VE in a 43-year-old Asian male with a history of oral and labial herpes. The patient presented with high-grade fever, headache, urinary retention, unresponsiveness, and apathy. Elevated levels of protein and GFAP-IgG were observed in the cerebrospinal fluid (CSF), and enhanced brain magnetic resonance imaging (MRI) revealed linear enhancement oriented radially to the ventricles. Treatment with intravenous immunoglobulin (IVIG) resulted in symptom relief, reduced lesion enhancement, and decreased protein levels. This case report highlights bimodal encephalitis with no discernible interval between VE and autoimmune GFAP astrocytopathy, which poses diagnostic challenges. Notably, autoimmune GFAP astrocytopathy is a novel form of autoimmune encephalitis, and its treatment lacks sufficient clinical experience. Intriguingly, our patient demonstrated sensitivity to IVIG, a treatment that differed from past reports. Therefore, further exploration of treatment strategies for this condition is warranted. |
| first_indexed | 2024-03-12T01:14:05Z |
| format | Article |
| id | doaj.art-d8388832cf0741dc82c8da32ce2c728e |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-03-12T01:14:05Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-d8388832cf0741dc82c8da32ce2c728e2023-09-13T21:55:28ZengFrontiers Media S.A.Frontiers in Immunology1664-32242023-09-011410.3389/fimmu.2023.12580481258048Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitisPing Cheng0Ping Cheng1Wenjuan Huang2Meifang Yang3Meifang Yang4Zhiren Chen5Zhiren Chen6Yifan Geng7Yifan Geng8Xia Zhang9Weiwei Chen10Weiwei Chen11Department of Neurology, Graduate School, Bengbu Medical College, Bengbu, Anhui, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Clinical College, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Neurology, Graduate School, Bengbu Medical College, Bengbu, Anhui, ChinaDepartment of Neurology, Xuzhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaAutoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a treatable autoimmune disorder affecting the central nervous system. Despite extensive research, the exact etiology and pathogenesis of this condition remain unclear. In recent years, autoimmune encephalitis (AE) after viral encephalitis (VE) has gathered significant attention. Here, we present a case report of autoimmune GFAP astrocytopathy after VE in a 43-year-old Asian male with a history of oral and labial herpes. The patient presented with high-grade fever, headache, urinary retention, unresponsiveness, and apathy. Elevated levels of protein and GFAP-IgG were observed in the cerebrospinal fluid (CSF), and enhanced brain magnetic resonance imaging (MRI) revealed linear enhancement oriented radially to the ventricles. Treatment with intravenous immunoglobulin (IVIG) resulted in symptom relief, reduced lesion enhancement, and decreased protein levels. This case report highlights bimodal encephalitis with no discernible interval between VE and autoimmune GFAP astrocytopathy, which poses diagnostic challenges. Notably, autoimmune GFAP astrocytopathy is a novel form of autoimmune encephalitis, and its treatment lacks sufficient clinical experience. Intriguingly, our patient demonstrated sensitivity to IVIG, a treatment that differed from past reports. Therefore, further exploration of treatment strategies for this condition is warranted.https://www.frontiersin.org/articles/10.3389/fimmu.2023.1258048/fullglial fibrillary acidic protein (GFAP)viral encephalitis (VE)herpes simplex viral encephalitis (HSVE)encephalitiscase report |
| spellingShingle | Ping Cheng Ping Cheng Wenjuan Huang Meifang Yang Meifang Yang Zhiren Chen Zhiren Chen Yifan Geng Yifan Geng Xia Zhang Weiwei Chen Weiwei Chen Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis Frontiers in Immunology glial fibrillary acidic protein (GFAP) viral encephalitis (VE) herpes simplex viral encephalitis (HSVE) encephalitis case report |
| title | Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis |
| title_full | Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis |
| title_fullStr | Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis |
| title_full_unstemmed | Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis |
| title_short | Autoimmune GFAP astrocytopathy after viral encephalitis: a case report of bimodal overlapping encephalitis |
| title_sort | autoimmune gfap astrocytopathy after viral encephalitis a case report of bimodal overlapping encephalitis |
| topic | glial fibrillary acidic protein (GFAP) viral encephalitis (VE) herpes simplex viral encephalitis (HSVE) encephalitis case report |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1258048/full |
| work_keys_str_mv | AT pingcheng autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT pingcheng autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT wenjuanhuang autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT meifangyang autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT meifangyang autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT zhirenchen autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT zhirenchen autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT yifangeng autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT yifangeng autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT xiazhang autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT weiweichen autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis AT weiweichen autoimmunegfapastrocytopathyafterviralencephalitisacasereportofbimodaloverlappingencephalitis |