{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T19:54:45Z","timestamp":1771617285405,"version":"3.50.1"},"reference-count":10,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,2,24]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Autoimmune glial fibrillar acidic protein (GFAP) astrocytopathy is a rare autoimmune neuroinflammatory disorder that affects the central nervous system. We present a case of GFAP astrocytopathy in a middle-aged male who presented with constitutional symptoms, encephalopathy and lower extremity weakness and numbness. Initially MRI of the spine was normal, but he subsequently developed longitudinally extensive myelitis and meningoencephalitis. Workup for infectious aetiologies was negative and the patient\u2019s clinical course worsened despite broad antimicrobial coverage. Ultimately, he was found to have anti-GFAP antibodies in his cerebral spinal fluid consistent with GFAP astrocytopathy. He was treated with steroids and plasmapheresis with clinical and radiographic improvement. This case demonstrates the temporal evolution of myelitis on MRI in a case of steroid-refractory GFAP astrocytopathy.<\/jats:p>","DOI":"10.1136\/bcr-2022-248921","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T07:55:13Z","timestamp":1678434913000},"page":"e248921","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Radiographic evolution of myelitis in a case of glial fibrillary acidic protein (GFAP) astrocytopathy"],"prefix":"10.1136","volume":"16","author":[{"given":"Christopher E","family":"Goyne","sequence":"first","affiliation":[{"name":"Neurology, University of California, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Piccioni","sequence":"additional","affiliation":[{"name":"University of California, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Handwerker","sequence":"additional","affiliation":[{"name":"University of California Medical Center Hillcrest, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amutha","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Infectious Disease, University of California, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"2025082804313881000_16.3.e248921.1","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1001\/jamaneurol.2016.2549","article-title":"Autoimmune glial fibrillary acidic protein astrocytopathy: a novel meningoencephalomyelitis","volume":"73","author":"Fang","year":"2016","journal-title":"JAMA Neurol"},{"key":"2025082804313881000_16.3.e248921.2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24881"},{"key":"2025082804313881000_16.3.e248921.3","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3389\/fneur.2018.00251","article-title":"Overlapping autoimmune syndromes in patients with glial fibrillary acidic protein antibodies","volume":"9","author":"Yang","year":"2018","journal-title":"Front Neurol"},{"key":"2025082804313881000_16.3.e248921.4","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.3389\/fimmu.2018.02802","article-title":"Autoimmune glial fibrillary acidic protein astrocytopathy: a review of the literature","volume":"9","author":"Shan","year":"2018","journal-title":"Front Immunol"},{"key":"2025082804313881000_16.3.e248921.5","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1159\/000479948","article-title":"Treatment of autoimmune glial fibrillary acidic protein astrocytopathy: follow-up in 7 cases","volume":"24","author":"Yang","year":"2017","journal-title":"Neuroimmunomodulation"},{"key":"2025082804313881000_16.3.e248921.6","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/WCO.0000000000000676","article-title":"Autoimmune GFAP astrocytopathy","volume":"32","author":"Kunchok","year":"2019","journal-title":"Curr Opin Neurol"},{"key":"2025082804313881000_16.3.e248921.7","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/1352458520907900","article-title":"Frequency and characteristics of MRI-negative myelitis associated with MOG autoantibodies","volume":"27","author":"Sechi","year":"2021","journal-title":"Mult Scler"},{"key":"2025082804313881000_16.3.e248921.8","doi-asserted-by":"publisher","DOI":"10.1136\/ard.59.2.120"},{"key":"2025082804313881000_16.3.e248921.9","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307088005"},{"key":"2025082804313881000_16.3.e248921.10","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000012467","article-title":"Comparison of MRI lesion evolution in different central nervous system demyelinating disorders","volume":"97","author":"Sechi","year":"2021","journal-title":"Neurology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-248921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:31:46Z","timestamp":1756380706000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-248921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,10]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/bcr-2022-248921"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-248921","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}