Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
Department of Neurology, Graduate School of Medicine, Gifu University, Japan.
Intern Med. 2023 Feb 1;62(3):465-468. doi: 10.2169/internalmedicine.9724-22. Epub 2022 Jul 5.
Recent studies have reported that autoantibodies against glial fibrillary acidic protein (GFAP), a major cytoskeletal protein expressed in astrocytes, can lead to GFAP astrocytopathy, an autoimmune central nervous system inflammatory disease. We herein report the unique case of a 59-year-old Japanese woman with GFAP astrocytopathy who presented with characteristic symptoms, including signs of meningeal irritation, cerebellar ataxia, and bladder/rectal dysfunction, in the absence of specific findings on initial brain magnetic resonance imaging (MRI). The patient exhibited new abnormal changes mainly in the brainstem on follow-up MRI, illustrating the need to recognize that MRI abnormalities may appear later in GFAP astrocytopathy.
最近的研究报告称，胶质纤维酸性蛋白（GFAP）自身抗体——一种在星形胶质细胞中表达的主要细胞骨架蛋白——可导致 GFAP 星形胶质细胞病，这是一种自身免疫性中枢神经系统炎症性疾病。我们在此报告一例独特的 59 岁日本女性 GFAP 星形胶质细胞病病例，其具有特征性症状，包括脑膜刺激征、小脑共济失调和膀胱/直肠功能障碍，但初始脑磁共振成像（MRI）无特异性发现。该患者在随访 MRI 上主要表现为脑干新的异常改变，说明需要认识到 GFAP 星形胶质细胞病的 MRI 异常可能出现较晚。
