Case report: Atypical case of autoimmune glial fibrillary acidic protein astrocytopathy following COVID-19 vaccination refractory to immunosuppressive treatments

This case report describes an unusual instance of autoimmune GFAP-astrocytopathy (GFAP-A) that emerged following SARS-CoV-2 vaccination. GFAP-A is an inflammatory condition affecting the central nervous system. The patient's condition was notably resistant to standard immunosuppressive treatments. This is atypical, as GFAP-A generally responds well to such therapies. The brain biopsy revealed unusual pathological findings, including the presence of CD4+ lymphocytes and demyelination, adding to the uniqueness of this case.

• 1
  The patient developed GFAP-A shortly after receiving the SARS-CoV-2 vaccine, suggesting a possible link between vaccination and the onset of the autoimmune condition.
• 2
  The patient's GFAP-A was refractory to multiple immunosuppressive treatments, including methylprednisolone, plasma exchange, and immunoglobulin therapy.
• 3
  Brain biopsy revealed atypical pathological features, including infiltration of CD4+ lymphocytes and demyelination, which are not commonly observed in GFAP-A.