ReviewNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
EBV-associated autoimmune glial fibrillary acidic protein astrocytopathy with lumbosacral leptomeningeal enhancement: a case report and literature review.
Review in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAutoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a rare inflammatory central nervous system autoimmune disease. Viral pathogens, most notably Epstein-Barr virus (EBV), represent a major disease trigger. Classic spinal magnetic resonance imaging (MRI) manifestations of GFAP-A are characterized by long-segment T2-weighted hyperintensities surrounding the central canal and patchy intramedullary enhancement, whereas lumbosacral leptomeningeal involvement is extremely rare.
methodsWe report a 58-year-old male patient with EBV-associated GFAP-A featuring isolated lumbosacral leptomeningeal enhancement. We consequently conducted a literature review restricted to EBV-associated GFAP-A cases to characterize their clinical manifestations, laboratory examinations, therapeutic regimens, and prognoses.
resultsThe patient presented with fever, low back pain, progressive limb numbness and weakness, and urinary retention. Serum and cerebrospinal fluid (CSF) GFAP-immunoglobulin G (IgG) tests were positive. Concurrently, metagenomic next-generation sequencing detected EBV reads in the CSF, whereas plasma EBV DNA was negative. Contrast-enhanced lumbar MRI demonstrated smooth linear leptomeningeal enhancement along the spinal cord. The patient showed substantial neurological recovery after receiving methylprednisolone pulse therapy, antiviral agents, and rituximab. A literature analysis of 24 cases of EBV-associated GFAP-A indicated a predominance among young and middle-aged males. Prominent clinical features included fever, urinary retention, headache, limb weakness, and tremor, with CSF GFAP-IgG positivity reaching 87.5%. Glucocorticoids, intravenous immunoglobulin, and antiviral agents constituted the first-line therapies.
conclusionsEBV-associated GFAP-A can manifest as isolated lumbosacral leptomeningeal enhancement in the absence of classic intracranial radial perivascular enhancement. Combined antiviral and immunotherapy demonstrates favorable short-term efficacy, whereas long-term, B-cell-targeted maintenance therapy may reduce the risk of relapse.
Indexed as
Identifiers
42742776What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.