{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:44:32Z","timestamp":1792172672550,"version":"4.4.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Autoimmune glial fibrillary acidic protein astrocytosis (GFAP-A), a novel inflammatory autoimmune disorder of the central nervous system, manifests with insidious onset and demonstrates protean clinical manifestations, which frequently leads to diagnostic ambiguity in early disease stages. We describe three typical GFAP-A cases exhibiting multisystem neurological involvement. Our observations show that GFAP-A frequently clinically mimics tuberculous meningitis (TBM), autoimmune encephalitis (AE), neuromyelitis optica spectrum disorder (NMOSD), Parkinson\u2019s disease (PD), and other neurological diseases. Notably, isolated ataxia is a rare presentation in GFAP-A, which allows us usually to consider spinocerebellar ataxia (SCA). Currently, no established diagnostic criteria or standard treatment protocols exist for GFAP-A. Patients with GFAP-A respond well to corticosteroid therapy. We found detecting GFAP-IgG in cerebrospinal fluid or serum is essential for differentiation.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1546372","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T04:10:23Z","timestamp":1752552623000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Reports: Three cases of autoimmune glial fibrillary acidic protein astrocytosis in disguise"],"prefix":"10.3389","volume":"16","author":[{"given":"Wen","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyao","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junbin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiguang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaozhen","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youbi","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunye","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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":"B2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000676","article-title":"Autoimmune glial fibrillary acidic protein astrocytopathy","volume":"32","author":"Kunchok","year":"2019","journal-title":"Curr Opin Neurol"},{"key":"B3","doi-asserted-by":"publisher","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":"B4","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1002\/ana.24881","article-title":"Glial fibrillary acidic protein immunoglobulin G as biomarker of autoimmune astrocytopathy: Analysis of 102 patients","volume":"81","author":"Flanagan","year":"2017","journal-title":"Ann Neurol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-023-02268-0","article-title":"Autoimmune glial fibrillary acidic protein astrocytopathy: clinical analysis and review of 15 cases","volume":"123","author":"Lan","year":"2023","journal-title":"Acta Neurol Belg"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2018.04.016","article-title":"Autoimmune GFAP astrocytopathy: Prospective evaluation of 90 patients in 1 year","volume":"321","author":"Dubey","year":"2018","journal-title":"J Neuroimmunol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2021.577718","article-title":"Clinical, neuroradiological, diagnostic and prognostic profile of autoimmune glial fibrillary acidic protein astrocytopathy: A pooled analysis of 324 cases from published data and a single-center retrospective study","volume":"360","author":"Xiao","year":"2021","journal-title":"J Neuroimmunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102350","article-title":"Autoimmune glial fibrillary acidic protein astrocytopathy mimics infectious meningitis: Two case reports","volume":"45","author":"Yang","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-316583","article-title":"Clinical and immunological characteristics of the spectrum of GFAP autoimmunity: a case series of 22 patients","volume":"89","author":"Iorio","year":"2018","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2019.04.004","article-title":"Clinical characteristics of autoimmune GFAP astrocytopathy","volume":"332","author":"Kimura","year":"2019","journal-title":"J Neuroimmunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.55729\/2000-9666.1372","article-title":"Glial fibrillary acidic protein astrocytopathy - an autoimmune mimicker of CNS tuberculosis","volume":"14","author":"Hasan","year":"2024","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"B12","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-3-030-19515-1_1","article-title":"Overview of mechanisms underlying neuroimmune diseases","volume-title":"Neuroimmune Diseases. 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