Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature

被引：9

作者：

Nakamura, Sota ^{[1
]}

Fujioka, Teppei ^{[1
]}

Kawashima, Shoji ^{[1
]}

Kawaguchi, Takatsune ^{[2
]}

Mizuno, Masayuki ^{[1
]}

Omura, Masahiro ^{[1
]}

Okita, Kenji ^{[1
]}

Kimura, Akio ^{[3
]}

Shimohata, Takayoshi ^{[3
]}

Matsukawa, Noriyuki ^{[1
]}

机构：

[1] Nagoya City Univ, Dept Neurol, Grad Sch Med Sci, Nagoya, Aichi, Japan

[2] Nagoya City Univ, Dept Radiol, Grad Sch Med Sci, Nagoya, Aichi, Japan

[3] Gifu Univ, Dept Neurol, Grad Sch Med, Gifu, Japan

来源：

INTERNAL MEDICINE | 2021年 / 60卷 / 18期

关键词：

autoimmune GFAP astrocytopathy; glial fibrillary acidic protein (GFAP); adenosine deaminase (ADA); urinary retention; myoclonus; reversible splenial lesion; MILD ENCEPHALITIS/ENCEPHALOPATHY; CORPUS-CALLOSUM; MENINGITIS; CSF; MENINGOENCEPHALITIS; BINDING; CD26;

D O I：

10.2169/internalmedicine.6457-20

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 29-year-old man presented with a high-grade fever, headache, and urinary retention, in addition to meningeal irritation and myoclonus in his upper extremities. A cerebrospinal fluid (CSF) examination showed pleocytosis and high adenosine deaminase (ADA) levels with no evidence of bacterial infection, including Mycobacterium tuberculosis. T2-weighted brain magnetic resonance imaging showed transient hyper-intensity lesions at the splenium of the corpus callosum (SCC), bilateral putamen, and pons during the course of the disease. The CSF was positive for anti-glial fibrillary acidic protein (GFAP) antibodies. He was diagnosed with autoimmune GFAP astrocytopathy. The present case shows that the combination of an elevated ADA level in the CSF and reversible T2-weighted hyper-intensity on the SCC supports the diagnosis of autoimmune GFAP encephalopathy.

引用

页码：3031 / 3036

页数：6

共 29 条

[1]

Alborzi A, 2009, IRAN J ALLERGY ASTHM, V8, P117, DOI 08.02/ijaai.117119

[2] PRIMARY LEPTOMENINGEAL LYMPHOMA PRESENTING AS CEREBELLOPONTINE ANGLE LESION [J].

BERCIANO, J ;

JIMENEZ, C ;

FIGOLS, J ;

FERRERES, JC ;

COMBARROS, O ;

ARJONA, R ;

PASCUAL, J .

NEURORADIOLOGY, 1994, 36 (05) :369-371

[3]

Cristalli G, 2001, MED RES REV, V21, P105, DOI 10.1002/1098-1128(200103)21:2<105::AID-MED1002>3.0.CO

[4]

2-U

[5]

Dong RP, 1996, J IMMUNOL, V156, P1349

[6] Pearls & Oy-sters: Chronic mumps meningoencephalitis with low CSF glucose and acute hydrocephalus in an adult [J].

Escalza-Cortina, Ines ;

Azkune-Calle, Itxaso ;

Rodriguez-Sainz, Aida ;

Gomez-Beldarrain, Marian ;

Vicente-Olabarria, Inigo ;

Carlos Garcia-Monco, Juan .

NEUROLOGY, 2014, 82 (05) :E41-E43

[7] Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy A Novel Meningoencephalomyelitis [J].

Fang, Boyan ;

McKeon, Andrew ;

Hinson, Shannon R. ;

Kryzer, Thomas J. ;

Pittock, Sean J. ;

Aksamit, Allen J. ;

Lennon, Vanda A. .

JAMA NEUROLOGY, 2016, 73 (11) :1297-1307

[8] Mild Encephalitis/Encephalopathy with Reversible Splenial Lesion (MERS) due to Cytomegalovirus: Case Report and Review of the Literature [J].

Feraco, Paola ;

Porretti, Giulia ;

Marchio, Giuliana ;

Bellizzi, Maria ;

Recla, Mauro .

NEUROPEDIATRICS, 2018, 49 (01) :68-71

[9] Glial fibrillary acidic protein immunoglobulin G as biomarker of autoimmune astrocytopathy: Analysis of 102 patients [J].

Flanagan, Eoin P. ;

Hinson, Shannon R. ;

Lennon, Vanda A. ;

Fang, Boyan ;

Aksamit, Allen J. ;

Morris, P. Pearse ;

Basal, Eati ;

Honorat, Josephe A. ;

Alfugham, Nora B. ;

Linnoila, Jenny J. ;

Weinshenker, Brian G. ;

Pittock, Sean J. ;

McKeon, Andrew .

ANNALS OF NEUROLOGY, 2017, 81 (02) :298-309

[10] Elevated Adenosine Deaminase Levels in the Cerebrospinal Fluid in Immune Checkpoint Inhibitor-induced Autoimmune Encephalitis [J].

Fujiwara, Satoru ;

Mimura, Naoya ;

Yoshimura, Hajime ;

Fujimoto, Daichi ;

Ito, Munehiro ;

Mori, Ryobu ;

Ito, Jiro ;

Tomii, Keisuke ;

Kawamoto, Michi ;

Kohara, Nobuo .

INTERNAL MEDICINE, 2019, 58 (19) :2871-2874

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