A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis
A 66-year-old woman presented with 2 days of confusion, poor balance, and a recent ground level fall. She exhibited lower extremity weakness, urinary retention, and upper extremity resting tremor with cogwheel rigidity. Extensive work-up for electrolyte, infectious, and rheumatologic pathologies was...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2025-04-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0974 |
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| author | Olivia D. Keenum M. Cole Keenum Joshua Elder Kathryn Humes |
| author_facet | Olivia D. Keenum M. Cole Keenum Joshua Elder Kathryn Humes |
| author_sort | Olivia D. Keenum |
| collection | DOAJ |
| description | A 66-year-old woman presented with 2 days of confusion, poor balance, and a recent ground level fall. She exhibited lower extremity weakness, urinary retention, and upper extremity resting tremor with cogwheel rigidity. Extensive work-up for electrolyte, infectious, and rheumatologic pathologies was unremarkable, and she was ultimately found to have heavy chain neuronal intermediate filament (NIF-H) antibodies in the cerebrospinal fluid, supporting a diagnosis of NIF autoimmune encephalitis (AE). An increased awareness of AE and a high index of suspicion are key to prompt diagnosis and treatment. If diagnosed, cancer screening is recommended, because AE can be a paraneoplastic process. |
| format | Article |
| id | doaj-art-7fc87e1454684dfea22a9c3d6e2b7c63 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-7fc87e1454684dfea22a9c3d6e2b7c632025-08-20T03:06:09ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-04-014410.7326/aimcc.2024.0974A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune EncephalitisOlivia D. Keenum0M. Cole Keenum1Joshua Elder2Kathryn Humes31Medical College of Georgia at Augusta University, Augusta, Georgia1Medical College of Georgia at Augusta University, Augusta, Georgia1Medical College of Georgia at Augusta University, Augusta, Georgia1Medical College of Georgia at Augusta University, Augusta, GeorgiaA 66-year-old woman presented with 2 days of confusion, poor balance, and a recent ground level fall. She exhibited lower extremity weakness, urinary retention, and upper extremity resting tremor with cogwheel rigidity. Extensive work-up for electrolyte, infectious, and rheumatologic pathologies was unremarkable, and she was ultimately found to have heavy chain neuronal intermediate filament (NIF-H) antibodies in the cerebrospinal fluid, supporting a diagnosis of NIF autoimmune encephalitis (AE). An increased awareness of AE and a high index of suspicion are key to prompt diagnosis and treatment. If diagnosed, cancer screening is recommended, because AE can be a paraneoplastic process.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0974 |
| spellingShingle | Olivia D. Keenum M. Cole Keenum Joshua Elder Kathryn Humes A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis Annals of Internal Medicine: Clinical Cases |
| title | A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis |
| title_full | A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis |
| title_fullStr | A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis |
| title_full_unstemmed | A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis |
| title_short | A Case of Heavy Chain Neuronal Intermediate Filament Autoimmune Encephalitis |
| title_sort | case of heavy chain neuronal intermediate filament autoimmune encephalitis |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0974 |
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