Masqueraders of Autoimmunne Nodopathies - Two Rare Case Reports of Neurofascin 186 Antibody Positive Autoimmune Neuropathy

Abstract Nodoparanodopathies are a group of autoimmune peripheral neuropathies which present with subacute or chronic relapsing “chronic inflammatory demyelinating polyneuropathy like” chronic/relapsing sensorimotor and/or cranial and autonomic neuropathy which respond well to immunotherapy. We herein present two cases of antineurofascin NF186 antibody-related autoimmune neuropathy. One patient presented with subacute sensorimotor neuropathy and gait ataxia while the other patient presented with worsening of preexistent chronic sensorimotor neuropathy with subacute onset of respiratory distress and cranial nerve palsies. Both of them had a delay in diagnosis due to other overlapping causes of peripheral neuropathy. We highlight the red flags in peripheral neuropathy diagnosis where there could be coexistence of multiple etiologies, especially autoimmune neuropathy which is treatable that needs a high degree of suspicion along with proper evaluation protocol and management guidelines that need to be followed which can change the overall clinical course and improve prognosis.