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Upper Extremity Multifocal Neuropathy in a 10-Year-Old Boy Associated With NS6S Disaccharide Antibodies
Frederick Edelman1, Elie Naddaf2, Andrew J Waclawik3
1Child Neurology Division, Department of Neurology, University of Wisconsin Hospital and Clinics, Madison, WI, USA Edelman@neurology.wisc.edu.
Journal of Child Neurology
|July 20, 2014
Summary
A rare multifocal neuropathy in a child affecting one arm showed demyelinating and axonal changes. Treatment with intravenous immunoglobulin (IVIg) was effective, suggesting an immune-mediated cause for this pediatric neuropathy.
Area of Science:
- Pediatric Neurology
- Neuroimmunology
- Demyelinating Neuropathies
Background:
- Focal or multifocal immune-mediated neuropathies are uncommon in pediatric populations.
- These conditions may be underdiagnosed due to their rarity and varied presentations.
Observation:
- A 10-year-old boy presented with a multifocal neuropathy impacting a single upper extremity.
- The neuropathy exhibited both demyelinating and axonal changes with sensory involvement.
Findings:
- Laboratory analysis revealed elevated immunoglobulin M (IgM) antibodies targeting the NS6S antigen.
- The patient demonstrated a positive response to high-dose intravenous immunoglobulin (IVIg) therapy.
Implications:
- This case highlights a potential immune-mediated etiology for focal neuropathies in children.
- Early recognition and treatment with IVIg may be beneficial for similar pediatric cases.
- Further research is warranted to understand the pathogenesis and diagnostic markers of pediatric multifocal neuropathies.
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