临床误诊误治2025，Vol.38Issue(10)：31-37,7.DOI:10.3969/j.issn.1002-3429.2025.10.006
抗NF155抗体阳性自身免疫性郎飞结旁病误诊为腰椎间盘突出症的原因分析
Analysis of the Causes of Misdiagnosis of Anti-NF155 Antibody Positive Au-toimmune Paranodopathy as Lumbar Disc Herniation
摘要
Abstract
Objective To analyze the cause of misdiagnosis of anti-neurofascin 155(NF155)antibody positive auto-immune paranodopathy(APN)as lumbar disc herniation,so as to improve the understanding of this disease and reduce the clinical misdiagnosis rate.Methods The clinical data of a patient with anti-NF155 antibody positive APN who was misdiag-nosed in July 2024 were retrospectively analyzed,and the relevant literature was reviewed.Results The patient was admitted to the orthopaedic clinic as＂lumbar disc herniation＂ due to numbness in both lower limbs for more than 1 year and aggravation with lower back pain and lower limb pain for 15 d.Lumbar magnetic resonance imaging(MRI)did not show obvious nerve root compression,and symptoms did not relieve after pain therapy;therefore,the patient was transferred to the Department of Neurology.Subsequently,cerebrospinal fluid tests showed significant protein increase and protein-cell separation.The electro-myography of both lower extremities showed chronic damage to the L4～S1 nerve root innervation area of both lower extremities,sympathetic nerve dysfunction of both lower extremities,and positive anti-NF155 antibody detection in cerebrospinal fluid and the serum.The patient was diagnosed with anti-NF155 antibody positive APN,and the misdiagnosis lasted 23 d.After diagno-sis,the patient was given Glucocorticoid therapy and followed up for 2 weeks,and the clinical symptoms improved.Conclusion For chronic disease patients with clinical manifestations of multiple motor sensory peripheral neuropathy,the possibility of APN should be considered,and relevant antibody detection should be conducted and other etiologies should be ruled out,to make definite diagnosis and early treatment and achieve better prognosis.关键词
自身免疫性郎飞结旁病/神经束蛋白155/多发性神经根神经病/误诊/腰椎间盘突出症/鉴别诊断Key words
Autoimmune paranodopathy/Neurofascin 155/Polyradiculoneuropathy/Misdiagnosis/Lumbar disc her-niation/Differential diagnosis分类
临床医学引用本文复制引用
徐秀红,矫树生,周毅,刘军,智建霞,梁秀琪,李波..抗NF155抗体阳性自身免疫性郎飞结旁病误诊为腰椎间盘突出症的原因分析[J].临床误诊误治,2025,38(10):31-37,7.基金项目
河北省医学科学研究重点科技研究计划课题(20231594) （20231594）
