A case of anti-neurofascin 155 antibody-positive combined central and peripheral demyelination successfully treated with plasma exchange

  • Shimizu Mikito
    Department of Neurology, Osaka University Graduate School of Medicine
  • Koda Tohru
    Department of Neurology, Osaka General Medical Center
  • Nakatsuji Yuji
    Department of Neurology, Osaka University Graduate School of Medicine
  • Ogata Hidenori
    Department of Neurology, Kyushu University Graduate School of Medicine
  • Kira Jun-ichi
    Department of Neurology, Kyushu University Graduate School of Medicine
  • Mochizuki Hideki
    Department of Neurology, Osaka University Graduate School of Medicine

Bibliographic Information

Other Title
  • 単純血漿交換療法が奏功した抗neurofascin 155抗体陽性中枢末梢連合脱髄症の1例

Abstract

<p>A 21-year-old man was admitted to our hospital in June 2015. He felt paresthesia of toes in April 2015, which had been spreading upward, and he became difficult to walk in June. Nerve conduction study showed peripheral demyelinating neuropathy that met the diagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP), and the cerebrospinal fluid (CSF) examination revealed the remarkably increased protein level. In addition, magnetic resonance imaging of his brain showed a few plaques in white matter, so he was finally diagnosed with combined central and peripheral demyelination (CCPD). Moreover, anti-neurofascin155 (NF155) antibodies assayed in his serum and CSF turned out to be positive. Although he was treated with intravenous immunoglobulin and intravenous methylprednisolone, his symptoms were not ameliorated. However, plasma exchange therapy was apparently effective, and the titer of anti-NF155 antibody was reduced. Recently, the number of case reports of CIDP with CNS lesions has gradually been increasing, while the information about the diagnosis and the treatment responses are not enough. Thus, we reported our case with CCPD who was successfully treated with plasma exchange.</p>

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