Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy Mimicking Tuberculous Meningitis Following Epstein-Barr Virus Infection

Park, Sua; Lee, Inyoung; Lee, Chan-Nyoung; Kim, Hayom

doi:2026.44.4.349

J Korean Neurol Assoc > Volume 44(4); 2026 > Article

Case Report

Journal of the Korean Neurological Association 2026;44(4): 349-352. doi: https://doi.org/10.17340/jkna.2026.0033

결핵뇌수막염으로 오인된 엡스타인-바바이러스 감염 후의 자가면역아교세포섬유산성단백질별아교세포병증

박수아, 이인영, 이찬녕, 김하욤

고려대학교안암병원 신경과

Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy Mimicking Tuberculous Meningitis Following Epstein-Barr Virus Infection

Sua Park MD, Inyoung Lee MD, Chan-Nyoung Lee MD, PhD, Hayom Kim MD, PhD

Department of Neurology, Korea University Anam Hospital, Seoul, Korea

Corresponding Author: Hayom Kim ,Tel: +82-2-920-5510, Fax: +82-2-925-2472, Email: neurohy3@korea.ac.kr

Received: April 29, 2026 Revised: June 26, 2026 Accepted: July 7, 2026 Published online: November 1, 2026

Abstract

A 49-year-old man with fever, progressive encephalopathy, lymphocytic pleocytosis, rising cerebrospinal fluid adenosine deaminase, Epstein-Barr virus DNA detection, and multifocal cerebral vasospasm was suspected of infectious or tuberculous meningitis, but repeated negative tests for tuberculosis and other pathogens and cerebrospinal fluid anti-glial fibrillary acidic protein (GFAP) antibody positivity established autoimmune GFAP astrocytopathy, which improved after methylprednisolone pulse therapy and plasma exchange.

Key Words: Glial fibrillary acidic protein astrocytopathy | Meningoencephalitis | Tuberculous meningitis