Table 3. Clinical, Laboratory, Imaging, and Pathological Features of Patients With Peripheral Neuropathy.
| Patient No. | Clinical Findings | Onset to Maximum Severity | Electromyography | Magnetic Resonance Imaging | Cerebrospinal Fluid | Histopathological Findings | Antibodies | Connective-Tissue Markers | ESR/CRP |
|---|---|---|---|---|---|---|---|---|---|
| 3 | Asymmetric LE pain and weakness | Weeks to months | Axonal thoracolumbar polyradiculopathy | NA | Two-nucleated cell, protein, 0.071 g/dL; glucose, 71 mg/dL; OCB 0, cytology negative, paraneoplastic panel negative | NA | GM1 and GD1b negative, PNP antibody panel negative | ANA 0.1, SSA, SSB, RNP, Jo-1, Sm, and Scl-70 negative | CRP, 3 mg/L |
| 4 | Length-dependent UE and LE weakness and sensory loss | 3-4 wk | Severe length-dependent peripheral neuropathy with axonal and demyelinating features | C/T/L spine degenerative changes, no metastatic disease | NA | NA | NA | NA | CRP, 3.5 mg/L |
| 5 | Facial weakness, dyspnea, dysarthria | 1 wk | Demyelinating polyradiculoneuropathy | Enhancement of facial nerves | Twelve- nucleated cells; glucose, 95 mg/dL; protein, 0.192 g/dL; cytology “atypical” favoring reactive | NA | GQ1b, Ach, GM1, GD1b, and PNP antibody negative | NA | NA |
| 6 | Asymmetric distal UE and LE sensory loss and weakness | 2.5 mo | Severe length-dependent axonal sensorimotor neuropathy | NA | NA | Necrotizing vasculitis (Figure, C and D) | NA | ANCA, ANA, ENA, and RF negative | ESR, 38 mm/h |
Abbreviations: Ach, acetylcholine; ANA, antinuclear antigen; ANCA, antineutrophil cytoplasmic antibody; CRP, C-reactive protein; C/T/L, cervical, thoracic, lumbar; ESR, erythrocyte sedimentation rate; GD1b, ganglioside GD1b; GM1, ganglioside-monosialic acid; GQ1b, anti–ganglioside Q1b; Jo-1, histidyl tRNA synthetase; LE, lower extremity; NA, not applicable; OCB, oligoclonal bands; PM/Scl, anti-exosome; PNP, paraneoplastic; RF, rheumatoid factor; RNP, ribonucleoprotein; Scl 70, anti–topoisomerase I; Sm, Smith; SSA, Sjögren syndrome–related antigen A; SSB, Sjögren syndrome–related antigen B; UE, upper extremity.
SI conversion factors: To convert C-reactive protein level to nanomoles per liter, multiply by 9.524; glucose level to millimoles per liter, multiply by 0.0555; and protein level to grams per liter, multiply by 10.0.