CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1595653
Autoimmune GFAP Astrocytopathy Manifesting as Sintilimab-Induced Myelitis: A Case Report and Literature Review
Provisionally accepted
Xue Ma
Xing Qin*- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 (PD-1), programmed cell death protein 1 ligand, and cytotoxic T-lymphocyte-associated protein 4, are important therapeutic approaches for malignancies. However, these novel treatment measures are associated with immune-related adverse events. We report the first reported case of autoimmune GFAP astrocytopathy-associated myelitis in a patient with hepatocellular carcinoma that was treated with sintilimab (an anti-PD-1 monoclonal antibody) immunotherapy. Additionally, literature review identified 21 previously reported cases of PD-1 inhibitor-associated myelitis, demonstrating similar clinical features. All patients received ICI discontinuation and high-dose glucocorticoid therapy, with the addition of other immune therapies in 15 patients. Clinical improvement was observed in 13 patients. Clinicians should consider autoimmune GFAP astrocytopathy-associated myelitis as a potential differential diagnosis among patients exhibiting neurological symptoms during or following ICI therapy.
Keywords: autoimmune glial fibrillary acidic protein astrocytopathy, Myelitis, immune checkpoint inhibitors, Sintilimab, Glucocorticoids
Received: 14 May 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 Ma and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xing Qin, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.