• Michiko Izumi, Akiyuki Uzawa, Reiji Aoki, Masahide Suzuki, Koki Yoshizawa, Yutaro Suzuki, Akio Kimura, Takayoshi Shimohata, and Satoshi Kuwabara.
• Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
• Intern. Med. 2023 Feb 1; 62 (3): 465468465-468.

AbstractRecent studies have reported that autoantibodies against glial fibrillary acidic protein (GFAP), a major cytoskeletal protein expressed in astrocytes, can lead to GFAP astrocytopathy, an autoimmune central nervous system inflammatory disease. We herein report the unique case of a 59-year-old Japanese woman with GFAP astrocytopathy who presented with characteristic symptoms, including signs of meningeal irritation, cerebellar ataxia, and bladder/rectal dysfunction, in the absence of specific findings on initial brain magnetic resonance imaging (MRI). The patient exhibited new abnormal changes mainly in the brainstem on follow-up MRI, illustrating the need to recognize that MRI abnormalities may appear later in GFAP astrocytopathy.

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