Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature
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- Nakamura Sota
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Fujioka Teppei
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Kawashima Shoji
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Kawaguchi Takatsune
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Mizuno Masayuki
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Omura Masahiro
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Okita Kenji
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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- Kimura Akio
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
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- Shimohata Takayoshi
- Department of Neurology, Gifu University Graduate School of Medicine, Japan
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- Matsukawa Noriyuki
- Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan
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抄録
<p>A 29-year-old man presented with a high-grade fever, headache, and urinary retention, in addition to meningeal irritation and myoclonus in his upper extremities. A cerebrospinal fluid (CSF) examination showed pleocytosis and high adenosine deaminase (ADA) levels with no evidence of bacterial infection, including Mycobacterium tuberculosis. T2-weighted brain magnetic resonance imaging showed transient hyper-intensity lesions at the splenium of the corpus callosum (SCC), bilateral putamen, and pons during the course of the disease. The CSF was positive for anti-glial fibrillary acidic protein (GFAP) antibodies. He was diagnosed with autoimmune GFAP astrocytopathy. The present case shows that the combination of an elevated ADA level in the CSF and reversible T2-weighted hyper-intensity on the SCC supports the diagnosis of autoimmune GFAP encephalopathy. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 60 (18), 3031-3036, 2021-09-15
一般社団法人 日本内科学会
