^(18)F-FDG PET/MR成像早期诊断自身免疫性胶质纤维酸性蛋白星形胶质细胞病1例报告并文献复习  

A case report of early diagnosis of autoimmune glial fibrillary acidic protein astrocytopathy by ^(18)F-FDG PET/MR and literature review

作　　者：刘小菊 邓向斌 张朝钦 王红燕 王有金 余治健 LIU Xiaoju;DENG Xiangbin;ZHANG Chaoqin;WANG Hongyan;WANG Youjin;YU Zhijian(School of Biomedical Engineering,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound∥Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging∥Shenzhen University Medical School,Shenzhen 518060,Guangdong,China;Department of Infectious Diseases,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,Guangdong,China)

机构地区：[1]深圳大学医学部生物医学工程学院∥医学超声关键技术国家地方联合工程实验室∥广东省生物医学信息检测与超声成像重点实验室,广东深圳518060 [2]华中科技大学协和深圳医院传染病科,广东深圳518052

出　　处：《暨南大学学报(自然科学与医学版)》2025年第1期53-59,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家自然科学基金项目(82172283);广东省医学科学技术研究基金项目(B2023399)。

摘　　要：自身免疫性胶质纤维酸性蛋白星形胶质细胞病(autoimmune glial fibrillary acidic protein astrocytopathy,A-GFAP-A)是近10年来发现的一种罕见自身免疫性脑炎,其诊断依赖于临床症状、影像学和抗体检测,多数患者需要数月甚至更长时间才能明确诊断。由于在早期诊断该疾病极具挑战性,且缺乏相关的临床指南,故国内外罕见关于此类病例的早期诊治情况的报道。本文报道了1例以高热、头痛为起始症状并伴有持续性低钠血症的患者,借助^(18)F-氟代脱氧葡萄糖正电子发射/磁共振计算机断层显像(^(18)F fludeoxyglucose positron emission tomography/magnetic resonance,^(18)F-FDG PET/MR)成像结合抗体检测,在其发病后约1月诊断为A-GFAP-A,对其进行了免疫治疗,最终预后良好。本研究旨在为A-GFAP-A患者的临床早期诊治提供一定的参考。Autoimmune glial fibrillary acidic protein astrocytopathy(A-GFAP-A)is a rare autoimmune encephalitis discovered in the last decade.The diagnosis depends on clinical symptoms,imaging,and antibody testing.Most cases require several months or even longer to make a definite diagnosis.Due to early-stage diagnosis of this condition poses significant challenges,and there is a lack of relevant clinical guidelines,there are few reports at home and abroad on early diagnosis and treatment in such cases.This paper reported a case of high fever and headache as the initial symptoms,accompanied by persistent hyponatremia.With the help of ^(18)F-fludeoxyglucose-positron emission tomography/magnetic resonance(^(18)F-FDG PET/MR)imaging combined with antibody testing,the patient was diagnosed with anti-GFAP encephalitis approximately one month after symptom onset,and evaluated the patient′s immunotherapy efficacy,leading to a favorable prognosis for the patient.This case provides a certain reference for the early clinical diagnosis and treatment of such patients.

关 键 词：自身免疫性胶质纤维酸性蛋白星形胶质细胞病 低钠血症 ^(18)F-氟代脱氧葡萄糖正电子发射/磁共振计算机断层显像 免疫治疗 

分 类 号：R741.04[医药卫生—神经病学与精神病学]