Glial fibrillary acidic protein antibody-associated astrocytopathy presents isolated spinal cord enhancement: A case report
Abstract
RATIONALE: Glial fibrillary acidic protein antibody-associated astrocytopathy (GFAP-A) is an autoimmune central nervous system inflammatory disorder diagnosed via cerebrospinal fluid (CSF) glial fibrillary acidic protein-immunoglobulin G detection. Clinically, it typically presents with meningoencephalitis or myelitis, accompanied by periventricular perivascular enhancement on brain magnetic resonance imaging (MRI) (findings that guide most routine diagnoses). Yet isolated spinal cord abnormalities (with negative brain MRI) in GFAP-A remain rarely reported, especially when occurring in patients with comorbidities like diabetes mellitus and active infection; these overlapping conditions often mask GFAP-A's typical features, consequently increasing the risk of clinical misdiagnosis. By reporting this atypical case, the study aims to supplement the existing imaging spectrum of GFAP-A and provide practical diagnostic references for complex clinical scenarios where underlying diseases obscure classic GFAP-A manifestations. It further carries significance in emphasizing the critical role of CSF GFAP-immunoglobulin G detection: this biomarker enables accurate identification of such atypical cases, directly addressing the misdiagnosis risk highlighted earlier.
PATIENT CONCERNS: A 47-year-old Chinese male patient with a 13-year history of type 2 diabetes mellitus was admitted to the hospital due to fever and headache. Initially, the patient was diagnosed with upper respiratory tract…
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