Published online Dec 6, 2023. doi: 10.12998/wjcc.v11.i34.8192
Peer-review started: September 18, 2023
First decision: November 9, 2023
Revised: November 20, 2023
Accepted: November 29, 2023
Article in press: November 29, 2023
Published online: December 6, 2023
Processing time: 78 Days and 22.6 Hours
A case of neuromyelitis optica spectrum disorder (NMOSD) with positive cerebrospinal fluid (CSF) anti-aquaporin-4 antibody (AQP4-IgG) and anti-glial fibrillary acidic protein IgG (GFAP-IgG) at the time of relapse was reported. The exact roles of GFAP-IgG in NMOSD are not fully understood and are the subject of ongoing research. This study revealed the possible connection between GFAP-IgG and the occurrence or development of diseases.
A 19-year-old woman was admitted to the hospital due to a constellation of symptoms, including dizziness, nausea, and vomiting that commenced 1 year prior, reoccurred 2 mo ago, and were accompanied by visual blurring that also began 2 mo ago. Additionally, she presented with slurred speech and ptosis, both of which emerged 1 mo ago. Notably, her symptoms deteriorated 10 d prior to admission, leading to the onset of arm and leg weakness. During hospitalization, magnetic resonance imaging showed high T2-fluid attenuated inversion recovery signals, and slightly high and equal diffusion-weighted imaging signals. The serum antibody of AQP4-IgG tested positive at a dilution of 1:100. CSF antibody testing showed positive results for GFAP-IgG at a dilution of 1:10 and AQP4-IgG at a dilution of 1:32. Based on these findings, the patient was diagnosed with NMOSD. She received intravenous methylprednisolone at a daily dose of 500 mg for 5 d, followed by a tapering-off period. Afterward, the rate of reduction was gradually slowed down and the timely use of immunosuppressants was imple
The CFS was slightly GFAP-IgG-positive during the relapse period, which can aid in the diagnosis and treatment of the disease.
Core Tip: Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disorder that affects the central nervous system. Here, a case of NMOSD with positive cerebrospinal fluid aquaporin-4 antibody and anti-glial fibrillary acidic protein antibody (GFAP-IgG) at the time of the relapse was reported. The exact role of GFAP-IgG in NMOSD remains a subject of debate and research, with some studies suggesting it is pathogenic and plays a role in disease development or progression. This case reveals the potential role of GFAP-IgG in NMOSD. The findings suggest a possible association between GFAP-IgG and the initiation or advancement of the disease.