CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1613142
This article is part of the Research TopicClinical and Immunological Phenotypic Characterization to better understand Pathogenesis and Response to Therapies in Systemic Autoimmune DiseasesView all 3 articles
Chronic Central Nervous System Aspergillosis with Coexisting GFAP and AQP4 Antibody Positivity: Case Report and Literature Review
Provisionally accepted
- 1Department of Medical Imaging, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
- 2Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
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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.
Keywords: Autoimmune antibodies, Central nervous system aspergillosis, Aquaporin-4 antibody, Immunity, Glial fibrillary acidic protein antibody (GFAP)
Received: 16 Apr 2025; Accepted: 18 Jun 2025.
Copyright: © 2025 一民, Zhao, Hao, Gao, Yang, Du, Wang and Zhou. 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:
曹 一民, Department of Medical Imaging, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
Lixia Zhou, Department of Medical Imaging, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
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