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A case of autoimmune GFAP astrocytopathy with profound weight loss and increased uptake in the spinal cord on 18 F‐FDG PET
Author(s) -
Osakada Yosuke,
Omote Yoshio,
Ikegami Ken,
Tadokoro Koh,
Sato Kota,
Hishikawa Nozomi,
Takemoto Mami,
Ohta Yasuyuki,
Yamashita Toru,
Kimura Akio,
Abe Koji
Publication year - 2021
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12441
Subject(s) - medicine , hyperintensity , spinal cord , methylprednisolone , prednisolone , anorexia , multiple sclerosis , lumbar , myelitis , magnetic resonance imaging , nuclear medicine , pathology , radiology , anesthesia , psychiatry
A 76‐year‐old man presented with subacute onset of progressive cognitive impairment, anorexia, tremor, ataxic gait, and urinary dysfunction. He had lost 17 kg in 9 months before his admission (due to persistent anorexia). A brain MRI showed a typical radial pattern of periventricular gadolinium enhancement and longitudinally extensive hyperintensity from cervical to lumbar spinal cord. 18 F ‐ FDG PET newly revealed an increased uptake of the tracer in the cervical and lower thoracic cords. After an intravenous methylprednisolone (1000 mg/d for 3 days) followed by oral prednisolone 40 mg/d, his clinical symptoms and abnormal MRI lesions improved. Anti‐GFAP antibodies were subsequently identified in CSF obtained on admission, confirming the diagnosis of autoimmune GFAP astrocytopathy.