Equiza J, Rodríguez-Antigüedad J, Campo-Caballero D, Iruzubieta P, Prada Á, Roncancio A, Fernández E, Ganzarain Oyarbide M, Arruti M, Urtasun MA, Castillo-Triviño T. Autoimmune GFAP astrocytopathy presenting with remarkable CNS hyperexcitability and oculogyric crises.
J Neuroimmunol 2021;
359:577695. [PMID:
34416409 DOI:
10.1016/j.jneuroim.2021.577695]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 11/26/2022]
Abstract
The autoimmune GFAP astrocytopathy has been associated with meningoencephalomyelitis that usually responds to glucocorticoids. We report a 20-year-old man that developed an acute and severe meningoencephalomyelitis with remarkable CNS hyperexcitability and oculogyric crises. CSF analysis showed hypoglycorrhachia, pleocytosis, elevated ADA, and CSF-immunofluorescence characteristic of autoimmune GFAP astrocytopathy. MRI showed lesions at thalamus, corpus-callosum, dorsal pons and dentate nucleus with associated myelitis. Immunotherapy led to a full recovery, although MRI activity was observed at follow-up. CNS hyperexcitability, typically seen in other immune-mediated syndromes, represents a novel presenting form to be included as part of the clinical spectrum of this entity.
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