# Case Report: Cerebrospinal fluid eosinophilia in adult autoimmune GFAP astrocytopathy

## TL;DR

A 30-year-old man with autoimmune GFAP astrocytopathy showed high levels of eosinophils in his cerebrospinal fluid, which decreased after treatment.

## Contribution

This case report highlights a previously unobserved high level of CSF eosinophilia in autoimmune GFAP astrocytopathy.

## Key findings

- The patient's CSF showed marked eosinophilia, higher than previously reported in similar cases.
- Eosinophil levels in CSF decreased after methylprednisolone therapy, along with clinical improvement.
- The findings suggest a possible role of eosinophils in the disease's progression.

## Abstract

A 30-year-old Chinese male diagnosed with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy presented with cerebrospinal fluid (CSF) eosinophilia. Magnetic resonance imaging (MRI) revealed no significant abnormalities; however, CSF analysis demonstrated the presence of GFAP-immunoglobulin G (IgG) antibodies. Notably, the CSF showed marked eosinophilia, which declined following methylprednisolone therapy and was accompanied by clinical improvement. The proportion of eosinophils in the CSF of this patient exceeded previously reported levels in cases of autoimmune GFAP astrocytopathy. These findings suggest a potential relationship between eosinophil infiltration and the pathogenesis of autoimmune GFAP astrocytopathy, indicating that eosinophils may contribute to disease progression.