Autoimmune GFAP astrocytopathy: Prospective evaluation of 90 patients in 1 year

被引:125
作者
Dubey, Divyanshu [1 ]
Hinso, Shannon R. [2 ,3 ]
Jolliffe, Evan A. [1 ]
Zekeridou, Anastasia [1 ]
Flanagan, Eoin P. [1 ]
Pittock, Sean J. [1 ,2 ,3 ]
Basal, Eati [2 ,3 ]
Drubach, Daniel A. [1 ]
Lachance, Daniel H. [1 ]
Lennon, Vanda A. [1 ,2 ,3 ,4 ]
McKeon, Andrew [1 ,2 ,3 ]
机构
[1] Mayo Clin, Dept Neurol, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Lab Med, Rochester, MN 55905 USA
[3] Mayo Clin, Dept Pathol, Rochester, MN 55905 USA
[4] Mayo Clin, Dept Immunol, Rochester, MN 55905 USA
关键词
Autoimmune; Meningoencephalomyelitis; Glial fibrillary astrocytic protein; Pediatric; Cerebrospinal fluid; ACIDIC PROTEIN ASTROCYTOPATHY; INFECTIOUS ENCEPHALITIS; EPIDEMIOLOGY; DIAGNOSIS;
D O I
10.1016/j.jneuroim.2018.04.016
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In this prospective evaluation of serum and CSF samples, all but two CSF GFAP alpha-lgG positive patients had autoimmune meningoencephalomyelitis while serum GFAP alpha-IgG positivity alone was less specific. Phenotypes were diverse among patients that were serum positive only. Adult and pediatric clinical presentations were similar. Most patients were immunotherapy responsive. Co-existing NMDA-R-IgG and cancer were associated with lack of response to first-line immunotherapy. Among patients with follow-up information, 18% had relapses. This study demonstrates CSF GFAP alpha-IgG is a specific autoimmune meningoencephalomyelitis biomarker, with favorable corticosteroid response. Lack of response should prompt evaluation for co-existing NMDA-R-IgG or malignancy.
引用
收藏
页码:157 / 163
页数:7
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