Evidence map›Paper›PMID 41862703›Full record

ReviewJournal of neurology2026

Clinical characteristics of autoimmune GFAP astrocytopathy with concomitant Epstein-Barr virus positivity: a case series of 12 patients and literature review.

Zhentang Cao, Haiman Hou, Hao Liu, Bo Li, Xudong Zhang, Lu Zhao

Abstract readReview
PubMed Publisher
In one paragraph

Review in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Zhentang CaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.ORCID http://orcid.org/0000-0003-2095-4103
Haiman HouDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Hao LiuDepartment of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Bo LiDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Xudong ZhangDepartment of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. fcczhangxd@zzu.edu.cn.
Lu ZhaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. fcczhaol2@zzu.edu.cn.

Funding

Henan Provincial Medical Science and Technology Research Joint Venture Project LHGJ20230251National Natural Science Foundation of China No.82070210
6 · The paper itself

Abstract

backgroundAutoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a novel autoimmune central nervous system (CNS) disorder. Epstein-Barr virus (EBV) has been implicated in various neurological diseases, yet GFAP-A with concomitant Epstein-Barr virus positivity is poorly understood.

methodsWe retrospectively analyzed 12 patients with concomitant EBV and GFAP positivity admitted between January 2022 and September 2025, and performed a literature review. Clinical, imaging, laboratory features, treatments, and outcomes were evaluated.

resultsIn our cohort, the median age at onset was 52.5 years (58% male). The predominant phenotype was meningo-encephalomyelitis (33%), with headache (100%) and fever (92%) as common symptoms. Peripheral nervous system involvement was noted in 16%. CSF analysis showed pleocytosis (100%) and elevated protein levels. MRI revealed T2/FLAIR hyperintensities in 67%, mainly in white matter and brainstem, and spinal lesions in 73%, including longitudinally extensive transverse myelitis (27%). All received antiviral and immunotherapy, with most showing improvement after intravenous methylprednisolone (± IVIG). At a median 32-month follow-up, only one relapsed, two died, and 80% of survivors achieved good outcomes (mRS < 3). Literature review (32 cases) showed similar features and immunotherapy responsiveness. Overall recurrence and mortality rates were both 7%.

conclusionsIn this small series, cases with concomitant EBV and GFAP positivity showed overlapping clinical features with classical GFAP-A and generally favorable responses to immunotherapy. Early recognition and CSF-based GFAP antibody testing may help improve patient outcomes; however, further studies are needed to confirm these findings.

Indexed as

AstrocytesAutoimmune Diseases of the Nervous SystemEpstein-Barr Virus InfectionsGlial Fibrillary Acidic ProteinAdultAgedFemaleHerpesvirus 4, HumanHumansMaleMiddle AgedRetrospective StudiesGFAP protein, humanGlial Fibrillary Acidic ProteinAutoimmune glial fibrillary acidic protein astrocytopathyClinical characteristicsEncephalitisEpstein–Barr virusGlial fibrillary acidic protein

Identifiers

PMID41862703

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