Case report: A man with acute onset of asymmetric motor and sensory loss
DOI:
https://doi.org/10.17161/rrnmf.v7i1_2026.24285Keywords:
Guillain Barrè Syndrome, infection, COVID-19, Viral infections, Pneumonia, Neuromuscular complications, Immunosuppression, Guillain-Barré syndrome, Miller Fisher syndrome, Myelitis, Myasthenia gravisAbstract
Acute and progressive sensorimotor neuropathies present a diagnostic challenge, particularly in immunocompromised patients. A thorough approach is required to distinguish between autoimmune, infectious, and inflammatory causes.
We present the case of a 44-year-old male with seropositive rheumatoid arthritis on immunosuppressive therapy, initially hospitalized for necrotizing pancreatitis, who developed a rapidly progressive asymmetric sensorimotor neuropathy with distal necrosis. Electrodiagnostic studies revealed a length-dependent axonal neuropathy, and cerebrospinal fluid analysis identified a potential infectious trigger. Given his immuno-compromised state, further investigation was warranted to determine the underlying etiology.
This case highlights the complexities of diagnosing acute neuropathies in immunocompromised patients, emphasizing the importance of broad differential considerations, timely electrodiagnostic testing, and targeted investigations to guide management.
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Copyright (c) 2026 Leah Naasz, MS4, Mykayla Vollmer, MD, Nessim Amin, MD, Abram R. Wahba, MD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
