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Glial fibrillary acidic protein antibody-positive meningoencephalomyelitis
  1. Angeliki Zarkali1,
  2. Oliver Cousins1,
  3. Dilan Athauda1,2,
  4. Samuel Moses3,
  5. Nicholas Moran1,4,
  6. Sreedharan Harikrishnan1,4
  1. 1East Kent Neurology Unit, East Kent University Hospitals NHS Foundation Trust, Canterbury, UK
  2. 2University College London, London, UK
  3. 3East Kent Microbiology and Virology, East Kent University Hospitals NHS Foundation Trust, Canterbury, UK
  4. 4King’s College London, London, UK
  1. Correspondence to Dr Angeliki Zarkali, East Kent Neurology Unit, East Kent University Hospitals NHS Foundation Trust, Margate CT9 4AN, UK; angeliki.zarkali{at}nhs.net

Abstract

Glial fibrillary acidic protein antibody-positive meningoencephalomyelitis is a newly described, possibly under-recognised, severe inflammatory condition of the nervous system. The clinical presentation is variable but most commonly is a combination of meningitis, encephalitis and myelitis; other manifestations may include seizures, psychiatric symptoms and tremor. There is a significant association with malignancies, often occult, and with other autoimmune conditions. Although the disease responds well to corticosteroids acutely, it typically relapses when these are tapered, and so patients need long-term immunosuppression. We report a young man presenting with subacute meningoencephalitis and subsequent myelitis, and discuss the typical presentation and management of this severe but treatable condition.

  • immunology
  • meningoencephalitis
  • myelopathy

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Footnotes

  • Contributors All authors provided clinical care to the patient. AZ drafted the first version of the manuscript, and all authors contributed to and have approved the final version of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Jackie Palace, Oxford, UK.

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