Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study

Frontiers in Pediatrics

Jing Li¹  Haixia Huang¹  Siwei Lu¹  Ke Bai¹  Yueqiang Fu¹  Yunni Ran¹  Hongxing Dang¹ 

[1] Intensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, China;Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China;

关键词: child;    glial fibrillary acidic protein astrocytopathy;    meningoencephalitis;    myelitis;    steroids;   

DOI  :  10.3389/fped.2020.626564

来源: Frontiers

【 摘 要 】

Autoimmune glial fibrillary acidic protein astrocytopathy is a novel form of autoimmune meningoencephalitis related to GFAP autoantibodies. This condition is still being characterized, and few pediatric patients have been identified. Here, we report three patients presenting with fever, nausea, and headache, following progressive disturbance of consciousness, limb weakness, dyspnea, or urine retention. MRI analysis revealed that T2-hyperintense lesions, or enhancement of the meninges and spinal cord. CSF and serum analyses revealed they were positive for GFAP antibody, confirming GFAP astrocytopathy diagnosis. Treating the patients with IVIG, with or without intravenous steroids, gradually improved their clinical symptoms. Our findings indicate that GFAP astrocytopathy should be considered in children who are clinically diagnosed with meningoencephalitis, whether or not myelitis is present, and if the MRI reveals enhancement of meninges or spinal cord, T2-hyperintense lesions, or a pattern of linear perivascular gadolinium enhancement. Suspected cases should be tested for GFAP antibody as soon as possible because these patients may benefit from immunotherapy.

【 授权许可】

CC BY