This special manifestation of the case may provide new clinical evidence for the imaging heterogeneity of GFAP-A, suggesting that in clinical practice, for patients with neurological symptoms complicated with infection and underlying metabolic diseases, if brain MRI has no typical abnormalities, it is necessary to pay attention to the combined evaluation of CSF GFAP-IgG detection and spinal cord MRI, so as to avoid ignoring the potential diagnosis of GFAP-A due to excessive attention to underlying diseases. Here, GFAP is linked to Other metabolic disease.