Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review
This article presents an unusual case of chronic central nervous system (CNS) aspergillosis with concurrent glial fibrillary acidic protein (GFAP)-IgG and aquaporin-4 (AQP4)-IgG seropositivity. The patient presented with progressive numbness and weakness of the extremities over three months. The dia...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613142/full |
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| author | Yimin Cao Xueying Zhao Shengpu Hao Haiqing Yang Duo Gao Shixuan Du Liang Wang LiXia Zhou |
| author_facet | Yimin Cao Xueying Zhao Shengpu Hao Haiqing Yang Duo Gao Shixuan Du Liang Wang LiXia Zhou |
| author_sort | Yimin Cao |
| collection | DOAJ |
| description | This article presents an unusual case of chronic central nervous system (CNS) aspergillosis with concurrent glial fibrillary acidic protein (GFAP)-IgG and aquaporin-4 (AQP4)-IgG seropositivity. The patient presented with progressive numbness and weakness of the extremities over three months. The diagnosis was established by a cell-based assay demonstrating double positivity for GFAP-IgG and AQP4-IgG; imaging revealed multiple foci in the right temporo-occipital lobe and cervical medulla. Surgical pathology confirmed parenchymal Aspergillus infection. Postoperative treatment with voriconazole was effective. This case represents, to our knowledge, the first report of chronic CNS aspergillosis with concurrent GFAP-IgG and AQP4-IgG positivity. These findings suggest that chronic fungal infections may induce multiple distinct antibody responses, thereby offering new insights into the mechanisms linking infection and immunity. Clinical vigilance is therefore warranted for the development of autoimmune antibodies following chronic fungal infections, and an early diagnosis may be facilitated by integrating clinical, imaging, and pathological evaluations. |
| format | Article |
| id | doaj-art-739dbe3e97464b51a02cb2f9b0ec64fe |
| institution | Matheson Library |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-739dbe3e97464b51a02cb2f9b0ec64fe2025-07-04T05:17:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16131421613142Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature reviewYimin Cao0Xueying Zhao1Shengpu Hao2Haiqing Yang3Duo Gao4Shixuan Du5Liang Wang6LiXia Zhou7Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Pathology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaThis article presents an unusual case of chronic central nervous system (CNS) aspergillosis with concurrent glial fibrillary acidic protein (GFAP)-IgG and aquaporin-4 (AQP4)-IgG seropositivity. The patient presented with progressive numbness and weakness of the extremities over three months. The diagnosis was established by a cell-based assay demonstrating double positivity for GFAP-IgG and AQP4-IgG; imaging revealed multiple foci in the right temporo-occipital lobe and cervical medulla. Surgical pathology confirmed parenchymal Aspergillus infection. Postoperative treatment with voriconazole was effective. This case represents, to our knowledge, the first report of chronic CNS aspergillosis with concurrent GFAP-IgG and AQP4-IgG positivity. These findings suggest that chronic fungal infections may induce multiple distinct antibody responses, thereby offering new insights into the mechanisms linking infection and immunity. Clinical vigilance is therefore warranted for the development of autoimmune antibodies following chronic fungal infections, and an early diagnosis may be facilitated by integrating clinical, imaging, and pathological evaluations.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613142/fullautoimmune antibodiescentral nervous system aspergillosisimmunityaquaporin-4 antibodyglial fibrillary acidic protein antibody |
| spellingShingle | Yimin Cao Xueying Zhao Shengpu Hao Haiqing Yang Duo Gao Shixuan Du Liang Wang LiXia Zhou Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review Frontiers in Immunology autoimmune antibodies central nervous system aspergillosis immunity aquaporin-4 antibody glial fibrillary acidic protein antibody |
| title | Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review |
| title_full | Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review |
| title_fullStr | Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review |
| title_full_unstemmed | Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review |
| title_short | Chronic central nervous system aspergillosis with coexisting GFAP and AQP4 antibody positivity: case report and literature review |
| title_sort | chronic central nervous system aspergillosis with coexisting gfap and aqp4 antibody positivity case report and literature review |
| topic | autoimmune antibodies central nervous system aspergillosis immunity aquaporin-4 antibody glial fibrillary acidic protein antibody |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1613142/full |
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