Autoimmune GFAP astrocytopathy after viral encephalitis: A case report

Area of Science:

• Neurology
• Immunology
• Neuroinflammation

Background:

• Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is an emerging autoimmune disorder.
• Herpes simplex viral encephalitis (HSVE) is a severe neurological infection.
• Differentiating HSVE from other neurological conditions can be challenging.

Observation:

• A 35-year-old female presented with symptoms including headache, fever, seizures, and psychiatric changes following HSVE.
• The patient tested positive for GFAP-IgG in serum and cerebrospinal fluid (CSF).
• MRI revealed characteristic radial periventricular enhancement.

Findings:

• Corticosteroid treatment led to symptom improvement, reduced MRI lesion enhancement, and decreased GFAP-IgG levels.
• This case establishes a potential association between HSVE and the development of autoimmune GFAP astrocytopathy.
• GFAP astrocytopathy was observed following a herpes simplex viral encephalitis diagnosis.

Implications:

• Autoimmune GFAP astrocytopathy may be a crucial differential diagnosis for patients with recurrent or atypical HSVE presentations.
• Understanding this association can improve diagnostic accuracy and treatment strategies for post-infectious neurological autoimmunity.
• This report highlights the importance of considering autoimmune etiologies in the context of viral encephalitis sequelae.