# A Rare Presentation of Non-systemic Vasculitic Neuropathy Mimicking Guillain-Barré Syndrome: A Case Report

## TL;DR

A 63-year-old woman's condition initially resembling Guillain-Barré syndrome was later diagnosed as non-systemic vasculitic neuropathy, highlighting the need for accurate diagnosis.

## Contribution

This case report presents a rare presentation of non-systemic vasculitic neuropathy mimicking Guillain-Barré syndrome.

## Key findings

- The patient's symptoms initially resembled acute motor axonal neuropathy but did not respond well to IVIG treatment.
- A skin biopsy confirmed non-systemic vasculitic neuropathy, while nerve biopsy was negative.
- The case emphasizes the importance of considering vasculitic neuropathy in differential diagnosis for similar presentations.

## Abstract

Vasculitic neuropathy typically presents as a painful, asymmetrical sensory-motor polyneuropathy, more commonly demonstrating a mononeuritis multiplex. We present the case of a 63-year-old woman who experienced acute-onset flaccid weakness in all four limbs following an episode of diarrhea. Guillain-Barré syndrome (GBS) was considered, which supported acute motor axonal neuropathy (AMAN) in the nerve conduction study (NCS). On the second day of treatment with intravenous immunoglobulin (IVIG), a vasculitic-type rash appeared along with limb pain. Furthermore, the asymmetrical sensory and motor weakness did not respond well to the treatment. A positive skin biopsy, however, with a negative nerve biopsy combined with repeat NCSs demonstrating mononeuritis multiplex, confirmed the diagnosis of non-systemic vasculitic neuropathy (NSVN) based upon Brighton Case Collaboration type 3. This presentation underlines the significance of considering vasculitic neuropathy as a potential diagnosis and highlights the importance of an accurate diagnosis, as this condition can be effectively treated.