Autoimmune myelopathy

Novel biomarker for a treatable
meningoencephalomyelitis

A novel astrocytic autoantibody, glial fibrillary acidic protein (GFAP), has recently been described by Mayo Clinic as a biomarker of a relapsing autoimmune meningoencephalomyelitis that is responsive to immunotherapies. Seropositivity distinguishes autoimmune GFAP meningoencephalomyelitis from disorders commonly considered in the differential diagnosis.

40%

In a Mayo Clinic study, 40% of patients with
GFAP-IgG were found to have co-existing antibodies.


When to consider testing

Consider autoimmune testing for patients presenting with spinal cord symptoms and one or more of the following:

  • Rapid onset and progression
  • Fluctuating course
  • Autoimmune stigmata (e.g., physical signs or personal/family history of diabetes, thyroid disorder, vitiligo, prematurely gray hair, myasthenia gravis, rheumatoid arthritis, systemic lupus erythematosus)

  • History of cancer
  • Smoking history (20+ pack years) or other cancer risk factors
  • Inflammatory cerebrospinal fluid
  • Neuroimaging atypical for degenerative etiology
  • Prior treatment with immune checkpoint inhibitors

Which test should I order?

Phenotypic evaluations

Our autoimmune myelopathy evaluation is part of an evolving approach to testing for autoimmune neurological disorders using phenotypic-specific evaluations that include multiple antibodies known for their disease association.


GFAP: A Novel Test for a Newly Identified Meningoencephalomyelitis

Mayo Clinic Laboratories is the only laboratory in the world to offer testing for a novel form of autoimmune meningoencephalomyelitis. Known as autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy, the condition was identified by Mayo Clinic in 2016. The GFAP antibody test is offered as part of Mayo Clinic Laboratories’ encephalitis and myelopathy evaluations.

Learn more about how to order these evaluations at your institution.

Additional resources

A Test in Focus: Autoimmune myelopathy

Andrew McKeon, M.B., B.Ch., M.D., gives an overview of this test available through Mayo Clinic Laboratories. He discusses when this testing should be ordered, how this testing improves upon previous testing approaches, what clinical action can be taken due to the results of this testing.

Webinar:
Autoimmune myelopathy

This “Specialty Testing” webinar will describe the clinical, radiologic, and serologic characteristics of autoimmune myelopathies and their mimics.

Study can improve understanding of how disability develops in MS

Mayo Clinic researchers have identified clear differences in brain and spinal cord scarring in patients with demyelinating diseases.