CASE REPORT
Epstein-Barr virus encephalitis complicated by glial fibrillary acidic protein astrocytopathy in a child: a case report
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Department of Pediatrics, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan 570311, China
 
 
Submission date: 2025-05-22
 
 
Final revision date: 2025-09-18
 
 
Acceptance date: 2025-11-09
 
 
Online publication date: 2026-06-09
 
 
Corresponding author
Hong Liang   

Department of Pediatrics, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan 570311, China
 
 
 
KEYWORDS
ABSTRACT
Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is an emerging autoimmune disorder of the central nervous system (CNS). Its potential association with Epstein-Barr virus (EBV) infection remains unclear, with only a few cases reported following CNS EBV infection. Here, we report a 6-year-old Chinese child who developed autoimmune GFAP astrocytopathy (GFAP-A) after EBV encephalitis. The patient presented with a 6-day history of headache and fever. Cerebrospinal fluid (CSF) analysis indicated viral encephalitis, and metagenomic next-generation sequencing confirmed EBV in the CSF. Brain imaging revealed cortical abnormalities, and elevated GFAP-immunoglobulin G titres were detected in both the CSF and serum. The patient showed marked clinical improvement following treatment with antivirals, corticosteroids and intravenous immunoglobulin. This case highlights the potential role of EBV as a trigger for autoimmune GFAP-A and underscores the importance of considering autoimmune mechanisms in paediatric CNS infections.
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ISSN:1426-3912
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