A case report of autoimmune glial fibrillary acidic protein astrocytopathy combined with Epstein-Barr virus infection.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology Pub Date : 2025-08-25 DOI:10.1186/s12883-025-04363-6

Qi An, Limei Liu

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引用次数: 0

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.

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自身免疫性胶质原纤维酸性蛋白星形细胞病合并eb病毒感染1例。

背景：本报告全面介绍了我院一名36岁男性患者的临床表现、诊断评估、治疗和预后，该患者被诊断为自身免疫性胶质纤维酸性蛋白星形细胞病（gmap - a）合并eb病毒（EBV）感染。gmap - a与病毒感染相关的报道并不多见。病例描述：患者表现出一系列症状，包括发热、步态不稳定（类似共济失调）、感觉类似于踩在棉花上、反应性下降、认知能力下降、尿和肠功能障碍以及持续打嗝。胸椎增强显像显示斑片状脑膜强化，冠状面可见中央管样强化。此外，在脑室白质、小脑和其他区域，除了上述的中央管样强化外，还可观察到放射性血管周围线状强化。脑脊液（CSF）的下一代测序（NGS）证实了人类疱疹病毒4型（EBV）的存在。基于细胞的试验（CBA）和基于组织的试验（TBA）验证了CSF中GFAP抗体的存在。在接受阿昔洛韦抗病毒治疗和大剂量皮质类固醇治疗后，患者表现出明显的临床改善。结论：推测病毒感染可能诱发自身免疫性脑膜脑炎。为本病的诊断提供更多相关病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Neurology 医学-临床神经学

CiteScore

4.20

自引率

0.00%

发文量

428

审稿时长

3-8 weeks

期刊介绍： BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.