Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study
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...
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doaj-cd3dd0ab555c4d739d9e40284dc903812021-01-25T11:51:44ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-01-01810.3389/fped.2020.626564626564Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective StudyHaixia Huang0Haixia Huang1Ke Bai2Ke Bai3Yueqiang Fu4Yueqiang Fu5Siwei Lu6Siwei Lu7Yunni Ran8Yunni Ran9Hongxing Dang10Hongxing Dang11Jing Li12Jing Li13Intensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaIntensive Care Unit, Key Medical Laboratory of Pediatrics, Chongqing Health Bureau, Ministry of Education, Chongqing, ChinaKey Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, ChinaAutoimmune 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.https://www.frontiersin.org/articles/10.3389/fped.2020.626564/fullchildglial fibrillary acidic protein astrocytopathymeningoencephalitismyelitissteroids |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haixia Huang Haixia Huang Ke Bai Ke Bai Yueqiang Fu Yueqiang Fu Siwei Lu Siwei Lu Yunni Ran Yunni Ran Hongxing Dang Hongxing Dang Jing Li Jing Li |
spellingShingle |
Haixia Huang Haixia Huang Ke Bai Ke Bai Yueqiang Fu Yueqiang Fu Siwei Lu Siwei Lu Yunni Ran Yunni Ran Hongxing Dang Hongxing Dang Jing Li Jing Li Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study Frontiers in Pediatrics child glial fibrillary acidic protein astrocytopathy meningoencephalitis myelitis steroids |
author_facet |
Haixia Huang Haixia Huang Ke Bai Ke Bai Yueqiang Fu Yueqiang Fu Siwei Lu Siwei Lu Yunni Ran Yunni Ran Hongxing Dang Hongxing Dang Jing Li Jing Li |
author_sort |
Haixia Huang |
title |
Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study |
title_short |
Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study |
title_full |
Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study |
title_fullStr |
Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study |
title_full_unstemmed |
Glial Fibrillary Acidic Protein Astrocytopathy in Pediatric Patients: A Retrospective Study |
title_sort |
glial fibrillary acidic protein astrocytopathy in pediatric patients: a retrospective study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2021-01-01 |
description |
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. |
topic |
child glial fibrillary acidic protein astrocytopathy meningoencephalitis myelitis steroids |
url |
https://www.frontiersin.org/articles/10.3389/fped.2020.626564/full |
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