Repeated Brain Magnetic Resonance Imaging Provides Clues for the Diagnosis of Autoimmune Glial Fibrillary Acid Protein Astrocytopathy

Takahiro Natori; Toko Fukao; Tsubasa Watanabe; Takafumi Kurita; Takanori Hata; Akio Kimura; Kazumasa Shindo; Takayoshi Shimohata; Yoshihisa Takiyama

doi:10.2169/internalmedicine.8964-21

CASE REPORTS

Repeated Brain Magnetic Resonance Imaging Provides Clues for the Diagnosis of Autoimmune Glial Fibrillary Acid Protein Astrocytopathy

Takahiro Natori, Toko Fukao, Tsubasa Watanabe, Takafumi Kurita, Takanori Hata, Akio Kimura, Kazumasa Shindo, Takayoshi Shimohata, Yoshihisa Takiyama

Author information

Takahiro Natori
Department of Neurology, University of Yamanashi Hospital, Japan
Toko Fukao
Department of Neurology, University of Yamanashi Hospital, Japan
Tsubasa Watanabe
Department of Neurology, University of Yamanashi Hospital, Japan
Takafumi Kurita
Department of Neurology, University of Yamanashi Hospital, Japan
Takanori Hata
Department of Neurology, University of Yamanashi Hospital, Japan
Akio Kimura
Department of Neurology, Gifu University Hospital, Japan
Kazumasa Shindo
Department of Neurology, University of Yamanashi Hospital, Japan
Takayoshi Shimohata
Department of Neurology, Gifu University Hospital, Japan
Yoshihisa Takiyama
Department of Neurology, University of Yamanashi Hospital, Japan

Keywords: autoimmune glial fibrillary acid protein astrocytopathy (GFAP-A), MRI, periventricular radial gadolinium enhancement, meningoencephalitis

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 19 Pages 2947-2950

DOI https://doi.org/10.2169/internalmedicine.8964-21

Browse “Advance online publication” version

Details

Abstract

We herein report a 47-year-old man with autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) revealed by periventricular radial linear enhancement on repeated brain magnetic resonance imaging (MRI). He presented with a history of headache and a fever followed by somnolence and worsening of consciousness. On admission (16 days from the onset), although lymphocytic pleocytosis and hypoglycorrhachia in the cerebrospinal fluid (CSF) were noted, initial brain MRI demonstrated non-specific findings. At 30 days from the onset, repeated brain MRI revealed characteristic findings of GFAP-A, and we detected anti-GFAP antibodies in the CSF. Thus, repeated brain MRI provides clues for the diagnosis of GFAP-A.

Corresponding author

Register with J-STAGE for free!