Sjogrens Syndrome Complicated with Optic Neuromyelitis and Dual Positivity of AQP4 and GFAP Antibodies: A Case Report

A patient diagnosed with Sjogren's syndrome (SS) developed weakness and numbness in both lower limbs, accompanied by abdominal distension and sensory impairment in the left index and little fingers.Cervical magnetic resonance imaging (MRI) indicated the presence of longitudinal inflammatory lesions in the C3-C6 segments of the cervical spinal cord.The serum tests showed positive antiaquaporin-4 (AQP4) and anti-glial fibrillary acidic protein (GFAP) antibodies.After treatment with steroid pulse and immunosuppressive agents, the symptoms of limb numbness, abdominal distension, and sensory impairment in the left finger were significantly improved.Cervical spinal cord MRI indicated significant improvement in inflammatory lesions.Anti-GFAP antibodies are quite uncommon in cases of SS complicated with neuromyelitis optica, and it is necessary to identify the true autoimmune GFAP-astrocytopathy (GFAP-A), if it is positive.