Tuesday, February 07, 2017

Autoimmune meningoencephalitis associated with GFAP IgG antibodies.

Fung B et al.  Autoimmune glial fibrillary acidic protein astrocytopathy: a novel meningoencephalomyelitis.  JAMA Neurol 2016; 73: 1297.

Mayo labs has 134 cases out of 100,000 evaluated for autoimmune and paraneoplastic ab's as part of routine care.  Clinical presentation consists of headache, confusion, behavioral changes, lethargy, blurred vision, and trouble walking.  Exam can show papillitis, CN palsies, myelopathy.  CSF can show pleocytosis, highprotein, OCB'sm high IgG index.  MRI can show leptomeningeal enhancement, gyral enhancement.  At least half relapsed despite corticosteroids.  6/16 developed cancers

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