Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Department of Neurology, Gifu University Graduate School of Medicine, Japan.
Intern Med. 2024 Jan 15;63(2):337-339. doi: 10.2169/internalmedicine.2751-23. Epub 2023 Nov 13.
We herein report the first case of autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy after coronavirus disease 2019 (COVID-19). A 23-year-old man experienced fatigue, a fever, and headache 14 days after the resolution of COVID-19. He was severely disoriented and admitted to our hospital. On admission, the patient exhibited disorientation, headache, neck stiffness, myoclonus of both upper limbs, dysuria, and pyramidal signs. A blood examination revealed hyponatremia, and a cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis. The CSF test results were positive for anti-GFAPα antibodies. The patient was treated with methylprednisolone pulse therapy, followed by oral prednisolone, which quickly ameliorated his neurological abnormalities.
我们在此报告首例 COVID-19 后自身免疫性胶质纤维酸性蛋白 (GFAP) 星形胶质细胞病。一名 23 岁男性在 COVID-19 痊愈后 14 天出现疲劳、发热和头痛。他严重定向障碍，被收入我院。入院时，患者表现为定向障碍、头痛、颈项强直、上下肢肌阵挛、排尿困难和锥体束征。血液检查显示低钠血症，脑脊液 (CSF) 分析显示淋巴细胞增多。CSF 检测结果抗 GFAPα 抗体阳性。患者接受了甲基强的松龙脉冲治疗，随后口服泼尼松龙，迅速改善了他的神经异常。
