A 59-year-old man had developed visual abnormality, nausea, headache, and weight loss since three months before. The ophthalmologist found severe optic disc edema in both eyes, and referred him to our hospital. The patient had mild cerebellar ataxia. Increased cerebrospinal fluid pressure, increased protein and cell counts, positive oligoclonal band, and contrast-enhanced head MRI showed multiple linear perivascular radial gadolinium enhancement around bilateral lateral ventricles. His subjective and objective findings significantly improved with steroid treatment. The cerebrospinal fluid was found to be positive for glial fibrillary acidic protein (GFAP) antibodies, and a diagnosis of GFAP astrocytopathy was obtained. When optic edema or radial contrast effects was observed on contrast-enhanced MRI, GFAP astrocytopathy should be considerd. Prompt immunotherapy is required to circumvent the development of permanent visual impairment.
Keyphrases
- contrast enhanced
- diffusion weighted
- magnetic resonance imaging
- cerebrospinal fluid
- magnetic resonance
- computed tomography
- optical coherence tomography
- diffusion weighted imaging
- optic nerve
- weight loss
- early onset
- protein protein
- amino acid
- healthcare
- binding protein
- neuropathic pain
- case report
- dual energy
- bariatric surgery
- type diabetes
- ultrasound guided
- cell therapy
- spinal cord
- emergency department
- bone marrow
- roux en y gastric bypass
- gastric bypass
- body mass index
- glycemic control
- adverse drug
- chemotherapy induced
- replacement therapy