GFAP IgG associated inflammatory polyneuropathy.


Journal

Journal of neuroimmunology
ISSN: 1872-8421
Titre abrégé: J Neuroimmunol
Pays: Netherlands
ID NLM: 8109498

Informations de publication

Date de publication:
15 06 2020
Historique:
received: 25 02 2020
revised: 22 03 2020
accepted: 31 03 2020
pubmed: 10 4 2020
medline: 11 11 2020
entrez: 10 4 2020
Statut: ppublish

Résumé

GFAP (glial fibrillary acidic protein)-IgG is predominantly associated with meningoencephalomyelitis, and neuropathy presentations are rare. We reviewed clinical, electrodiagnostic and histopathological presentations of GFAP-IgG associated peripheral neuropathy. We identified six cases, five of whom had peripheral neuropathy as the initial presentation. Acute/subacute polyradicluoneuropathy or proximal nerve involvement was a common presentation. Three had demyelinating neuropathies on electrophysiological studies. Nerve biopsies (n = 2) demonstrated T-cell predominant perivascular inflammatory collections, and all patients with clinical follow up responded favorably to immunotherapy. GFAP neuropathy represents a potentially treatable immune-mediated neuropathy and can occur with or without co-existing meningoencephalomyelitis.

Sections du résumé

BACKGROUND
GFAP (glial fibrillary acidic protein)-IgG is predominantly associated with meningoencephalomyelitis, and neuropathy presentations are rare.
METHODS
We reviewed clinical, electrodiagnostic and histopathological presentations of GFAP-IgG associated peripheral neuropathy.
RESULTS
We identified six cases, five of whom had peripheral neuropathy as the initial presentation. Acute/subacute polyradicluoneuropathy or proximal nerve involvement was a common presentation. Three had demyelinating neuropathies on electrophysiological studies. Nerve biopsies (n = 2) demonstrated T-cell predominant perivascular inflammatory collections, and all patients with clinical follow up responded favorably to immunotherapy.
CONCLUSION
GFAP neuropathy represents a potentially treatable immune-mediated neuropathy and can occur with or without co-existing meningoencephalomyelitis.

Identifiants

pubmed: 32272393
pii: S0165-5728(20)30107-7
doi: 10.1016/j.jneuroim.2020.577233
pii:
doi:

Substances chimiques

Autoantibodies 0
Autoantigens 0
GFAP protein, human 0
Glial Fibrillary Acidic Protein 0
Immunoglobulin G 0
Immunosuppressive Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

577233

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Pritikanta Paul (P)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America.

Andrew McKeon (A)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America; Center of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States of America.

Sean J Pittock (SJ)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America; Center of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States of America.

Christopher J Klein (CJ)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America; Center of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States of America.

Shailee Shah (S)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America; Center of Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States of America; Northwestern Feinberg School of Medicine, Chicago, IL, United States of America.

Michel Toledano (M)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America.

John R Mills (JR)

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America.

Divyanshu Dubey (D)

Department of Neurology, Mayo Clinic, Rochester, MN, United States of America; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Dubey.Divyanshu@mayo.edu.

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Classifications MeSH