[Anti-NF155 antibody positive autoimmune nodopathy presenting as multiple mononeuropathy with predominantly superficial sensory disturbances].

Abstract

Anti-NF155 antibody positive autoimmune nodopathy typically presents with symmetric deep sensory disturbance, muscle weakness and tremor. Here, we report a unique case of anti-NF155 antibody positive autoimmune nodopathy presenting as multiple mononeuropathy with predominantly superficial sensory disturbances. A 35-year-old woman presented with progressive superficial sensory disturbances on the right side of her tongue and lip, the left lower limb, the right toes, and the right forehead over a period of 4 years. There was no deep sensory disturbance, muscle weakness, or tremor. Cerebrospinal fluid protein levels were markedly elevated (423 ‍mg/dl), and nerve conduction studies indicated demyelinating neuropathy. MRI revealed swelling and high signal intensity of both the lumbosacral plexuses and the right lingual nerve on short T₁ inversion recovery images. Later, serum anti-NF155 antibody was found out to be positive. Even when the neurological symptoms are not typical as nodopathy, we should explore the possibility of nodopathy in the cases in which cerebrospinal fluid protein levels are markedly high.