GFAP-A and Overlapping syndrome of MOG‑IgG‑associated disease and autoimmune GFAP astrocytopathy: case reports

Abstract Background : Autoimmune glial fibrillary acidic protein astrocytic lesion （GFAP-A）is a new central nervous system autoimmune disease first described in humans at the Mayo Clinic in 2016. The diagnosis mainly depends on the IgG antibody of GFAP in cerebrospinal fluid (CSF). Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a kind of inflammatory demyelinating disease of the central nervous system in which MOG antibodies are found in serology or cerebrospinal fluid. Today, clinicians also have a certain understanding of demyelinating diseases, but the mechanism of these diseases is still not very clear, so clinical cases are still worthy of attention and summary. Case presentation : We report a case of GFAP-A and a case of Overlapping syndrome of MOG‑IgG‑associated disease and autoimmune GFAP astrocytopathy. Our cases show that the severity of GFAP-A is no less severe than that of Overlapping syndrome of MOG‑IgG‑associated disease and autoimmune GFAP astrocytopathy, but this is only a case-based guess. Conclusions : Reading the literature, we found great heterogeneity in patients with these inflammatory demyelinating central nervous system diseases, which also brings difficulties to clinical diagnosis. Therefore, we believe that when clinically suspected demyelinating diseases of the central nervous system, APQ4, MOG, GFAP, MBP, and other related antibodies should be detected at the same time to avoid missed diagnosis.