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
- magnetic resonance imaging
- diffusion weighted
- cerebrospinal fluid
- magnetic resonance
- optical coherence tomography
- computed tomography
- diffusion weighted imaging
- optic nerve
- weight loss
- early onset
- protein protein
- healthcare
- case report
- bariatric surgery
- multiple sclerosis
- neuropathic pain
- binding protein
- sleep quality
- ultrasound guided
- ionic liquid
- stem cells
- cell therapy
- roux en y gastric bypass
- adipose tissue
- body mass index
- drug induced
- combination therapy
- physical activity
- peripheral blood