Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis

作者全名："Qin, Ningxiang; Wu, Xingguo; Wang, Jing; Wang, Wei; Wang, Xuefeng; Ma, Yuanlin; Wang, Liang"

作者地址："[Qin, Ningxiang; Wu, Xingguo; Wang, Jing; Wang, Wei; Wang, Xuefeng; Ma, Yuanlin; Wang, Liang] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China"

通信作者："Wang, L (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China."

来源：FRONTIERS IN NEUROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000954699300001

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：autoimmune GFAP astrocytopathy; tuberculous meningitis; meningoencephalitis; anti-GFAP antibody; case report

摘要："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."

基金机构："Joint Medical Research Project of Chongqing Science & Technology and Health Commission [2020FYYX081]; High-Level Medical Reserved Personnel Training Project of Chongqing; Natural Science Foundation of Yuzhong Direct, Chongqing [20190129]"

基金资助正文："This study was supported by the Joint Medical Research Project of Chongqing Science & Technology and Health Commission (2020FYYX081), High-Level Medical Reserved Personnel Training Project of Chongqing, and Natural Science Foundation of Yuzhong Direct, Chongqing (20190129)."