Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies
BackgroundGlial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder with a specific GFAP-IgG, often coexists with other antibodies.ObjectiveThe aim of this article was to study overlapping syndromes in autoimmune GFAP astrocytopathy.MethodsAntibody was dete...
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Frontiers Media S.A.
2018-04-01
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Series: | Frontiers in Neurology |
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Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2018.00251/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
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DOAJ |
author |
Xinguang Yang Xinguang Yang Huiming Xu Huiming Xu Meilin Ding Qingmei Huang Qingmei Huang Baikeng Chen Baikeng Chen Huacai Yang Huacai Yang Tianni Liu Tianni Liu Youming Long Youming Long Cong Gao Cong Gao |
spellingShingle |
Xinguang Yang Xinguang Yang Huiming Xu Huiming Xu Meilin Ding Qingmei Huang Qingmei Huang Baikeng Chen Baikeng Chen Huacai Yang Huacai Yang Tianni Liu Tianni Liu Youming Long Youming Long Cong Gao Cong Gao Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies Frontiers in Neurology glial fibrillary acidic protein autoimmune astrocytopathy antibody central nervous system |
author_facet |
Xinguang Yang Xinguang Yang Huiming Xu Huiming Xu Meilin Ding Qingmei Huang Qingmei Huang Baikeng Chen Baikeng Chen Huacai Yang Huacai Yang Tianni Liu Tianni Liu Youming Long Youming Long Cong Gao Cong Gao |
author_sort |
Xinguang Yang |
title |
Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies |
title_short |
Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies |
title_full |
Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies |
title_fullStr |
Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies |
title_full_unstemmed |
Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein Antibodies |
title_sort |
overlapping autoimmune syndromes in patients with glial fibrillary acidic protein antibodies |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2018-04-01 |
description |
BackgroundGlial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder with a specific GFAP-IgG, often coexists with other antibodies.ObjectiveThe aim of this article was to study overlapping syndromes in autoimmune GFAP astrocytopathy.MethodsAntibody was detected by indirect immunofluorescence assay. Patient data were analyzed retrospectively.ResultsThirty patients with positive GFAP-IgG were included, of whom 10 were defined as overlapping syndrome. Four patients with positive aquaporin-4 (AQP4)-IgG, two with N-methyl-d-aspartate receptor-IgG, three with unknown neuronal antibodies, and one with double AQP4 and myelin oligodendrocyte glycoprotein-IgG were identified. GFAP-IgG and other specific antibodies occurred simultaneously at the initial attack in eight patients. The main symptoms included fever, headache, ataxia, psychosis, hypersomnia, dyskinesia, dementia, seizure, myelitis, and optical symptoms. Brain magnetic resonance imaging in four patients revealed characteristic radial enhancing patterns in the white matter. Cortical abnormalities were found in four patients. Other brain abnormalities occurred in the hypothalamus, midbrain, pons, medulla, cerebellum, and meninges. Six patients exhibited lesions in the spinal cord. In a subgroup study, patients with overlapping syndrome were younger at onset than those with non-overlapping syndrome.ConclusionOverlapping antibodies are common in GFAP astrocytopathy. |
topic |
glial fibrillary acidic protein autoimmune astrocytopathy antibody central nervous system |
url |
http://journal.frontiersin.org/article/10.3389/fneur.2018.00251/full |
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doaj-946439bd05d14a15b1261f8587f3a2b22020-11-24T23:53:22ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-04-01910.3389/fneur.2018.00251330916Overlapping Autoimmune Syndromes in Patients With Glial Fibrillary Acidic Protein AntibodiesXinguang Yang0Xinguang Yang1Huiming Xu2Huiming Xu3Meilin Ding4Qingmei Huang5Qingmei Huang6Baikeng Chen7Baikeng Chen8Huacai Yang9Huacai Yang10Tianni Liu11Tianni Liu12Youming Long13Youming Long14Cong Gao15Cong Gao16Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Geriatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaDepartment of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaInstitute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, Guangzhou, ChinaBackgroundGlial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder with a specific GFAP-IgG, often coexists with other antibodies.ObjectiveThe aim of this article was to study overlapping syndromes in autoimmune GFAP astrocytopathy.MethodsAntibody was detected by indirect immunofluorescence assay. Patient data were analyzed retrospectively.ResultsThirty patients with positive GFAP-IgG were included, of whom 10 were defined as overlapping syndrome. Four patients with positive aquaporin-4 (AQP4)-IgG, two with N-methyl-d-aspartate receptor-IgG, three with unknown neuronal antibodies, and one with double AQP4 and myelin oligodendrocyte glycoprotein-IgG were identified. GFAP-IgG and other specific antibodies occurred simultaneously at the initial attack in eight patients. The main symptoms included fever, headache, ataxia, psychosis, hypersomnia, dyskinesia, dementia, seizure, myelitis, and optical symptoms. Brain magnetic resonance imaging in four patients revealed characteristic radial enhancing patterns in the white matter. Cortical abnormalities were found in four patients. Other brain abnormalities occurred in the hypothalamus, midbrain, pons, medulla, cerebellum, and meninges. Six patients exhibited lesions in the spinal cord. In a subgroup study, patients with overlapping syndrome were younger at onset than those with non-overlapping syndrome.ConclusionOverlapping antibodies are common in GFAP astrocytopathy.http://journal.frontiersin.org/article/10.3389/fneur.2018.00251/fullglial fibrillary acidic proteinautoimmuneastrocytopathyantibodycentral nervous system |