Glial Fibrillary Acidic Protein (GFAP) Autoimmunity in the Setting of Seropositive Rheumatoid Arthritis Treated with Etanercept

Research output: Contribution to journalArticle

Abstract

Introduction:Glial fibrillary acidic protein (GFAP) immunoglobulin G is a recently discovered biomarker of an autoimmune central nervous system disorder characterized by a steroid-responsive meningoencephalomyelitis.Case Report:A 63-year-old man with rheumatoid arthritis on etanercept presented with steroid-responsive subacute encephalopathy and foot drop. Brain and sural nerve biopsies demonstrated a T-cell perivascular infiltrate. Cerebrospinal fluid studies 18 months into the course of the illness demonstrated a GFAP antibody on mouse tissue immunofluorescence confirmed by cell-based assay. The patient was treated with steroids and cyclophosphamide leading to resolution of his symptoms.Conclusion:This case expands on the previously reported cases of GFAP immunoglobulin G autoimmunity by describing an associated inflammatory large fiber peripheral neuropathy.

Original languageEnglish (US)
Pages (from-to)152-154
Number of pages3
JournalNeurologist
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2019

Fingerprint

Glial Fibrillary Acidic Protein
Autoimmunity
Rheumatoid Arthritis
Steroids
Immunoglobulin G
Sural Nerve
Central Nervous System Diseases
Brain Diseases
Peripheral Nervous System Diseases
Cyclophosphamide
Fluorescent Antibody Technique
Cerebrospinal Fluid
Foot
Biomarkers
T-Lymphocytes
Biopsy
Antibodies
Brain
Etanercept

Keywords

  • encephalopathy
  • GFAP
  • neuroimmunology
  • neuropathy
  • TNF-inhibitor

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

@article{042b95ee482d4e94b0601f97cab18f5f,
title = "Glial Fibrillary Acidic Protein (GFAP) Autoimmunity in the Setting of Seropositive Rheumatoid Arthritis Treated with Etanercept",
abstract = "Introduction:Glial fibrillary acidic protein (GFAP) immunoglobulin G is a recently discovered biomarker of an autoimmune central nervous system disorder characterized by a steroid-responsive meningoencephalomyelitis.Case Report:A 63-year-old man with rheumatoid arthritis on etanercept presented with steroid-responsive subacute encephalopathy and foot drop. Brain and sural nerve biopsies demonstrated a T-cell perivascular infiltrate. Cerebrospinal fluid studies 18 months into the course of the illness demonstrated a GFAP antibody on mouse tissue immunofluorescence confirmed by cell-based assay. The patient was treated with steroids and cyclophosphamide leading to resolution of his symptoms.Conclusion:This case expands on the previously reported cases of GFAP immunoglobulin G autoimmunity by describing an associated inflammatory large fiber peripheral neuropathy.",
keywords = "encephalopathy, GFAP, neuroimmunology, neuropathy, TNF-inhibitor",
author = "Smith, {Kelsey M.} and Shreyasee Amin and Jones, {Lyell K.} and Lachance, {Daniel H.} and Flanagan, {Eoin P.} and Jentoft, {Mark E.} and Kantarci, {Orhun H.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1097/NRL.0000000000000243",
language = "English (US)",
volume = "24",
pages = "152--154",
journal = "Neurologist",
issn = "1074-7931",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Glial Fibrillary Acidic Protein (GFAP) Autoimmunity in the Setting of Seropositive Rheumatoid Arthritis Treated with Etanercept

AU - Smith, Kelsey M.

AU - Amin, Shreyasee

AU - Jones, Lyell K.

AU - Lachance, Daniel H.

AU - Flanagan, Eoin P.

AU - Jentoft, Mark E.

AU - Kantarci, Orhun H.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Introduction:Glial fibrillary acidic protein (GFAP) immunoglobulin G is a recently discovered biomarker of an autoimmune central nervous system disorder characterized by a steroid-responsive meningoencephalomyelitis.Case Report:A 63-year-old man with rheumatoid arthritis on etanercept presented with steroid-responsive subacute encephalopathy and foot drop. Brain and sural nerve biopsies demonstrated a T-cell perivascular infiltrate. Cerebrospinal fluid studies 18 months into the course of the illness demonstrated a GFAP antibody on mouse tissue immunofluorescence confirmed by cell-based assay. The patient was treated with steroids and cyclophosphamide leading to resolution of his symptoms.Conclusion:This case expands on the previously reported cases of GFAP immunoglobulin G autoimmunity by describing an associated inflammatory large fiber peripheral neuropathy.

AB - Introduction:Glial fibrillary acidic protein (GFAP) immunoglobulin G is a recently discovered biomarker of an autoimmune central nervous system disorder characterized by a steroid-responsive meningoencephalomyelitis.Case Report:A 63-year-old man with rheumatoid arthritis on etanercept presented with steroid-responsive subacute encephalopathy and foot drop. Brain and sural nerve biopsies demonstrated a T-cell perivascular infiltrate. Cerebrospinal fluid studies 18 months into the course of the illness demonstrated a GFAP antibody on mouse tissue immunofluorescence confirmed by cell-based assay. The patient was treated with steroids and cyclophosphamide leading to resolution of his symptoms.Conclusion:This case expands on the previously reported cases of GFAP immunoglobulin G autoimmunity by describing an associated inflammatory large fiber peripheral neuropathy.

KW - encephalopathy

KW - GFAP

KW - neuroimmunology

KW - neuropathy

KW - TNF-inhibitor

UR - http://www.scopus.com/inward/record.url?scp=85071761021&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071761021&partnerID=8YFLogxK

U2 - 10.1097/NRL.0000000000000243

DO - 10.1097/NRL.0000000000000243

M3 - Article

C2 - 31478999

AN - SCOPUS:85071761021

VL - 24

SP - 152

EP - 154

JO - Neurologist

JF - Neurologist

SN - 1074-7931

IS - 5

ER -