A CASE REPORT ON DISTAL SYMMETRICAL SENSORY AUTOIMMUNE NEUROPATHY
Periya Karuppan A. R., Visali K., Yazhini S., Keerthiga J., Danush M., Nalinishri R. S., Dr. M. Dheenadayalan*
Background: The Distal Symmetrical Sensory Autoimmune Neuropathy (DSSAN) is a rare autoimmune disease that affects the peripheral nervous system resulting in distal sensory impairment. This condition is known to cause symptoms like numbness, tingling, pain, sensory ataxia, and instability when walking. Given that DSSAN can be confused with diabetes, nutrition-related, infection-induced, or hereditary neuropathy, diagnosis is difficult. Case Presentation: This is the case of a 52-year-old man had a history of gradual numbness, tingling sensations, burning pain, and difficulty balancing while walking for six months. Neurological examination showed symmetrical distal sensory loss with abnormal vibration and proprioception sensation but normal motor sensation. Blood tests ruled out metabolic and infectious causes of neuropathy. Autoimmune profile was found to have a positive anti-nuclear antibody (ANA) and anti-Ro/SSA antibody with raised inflammatory markers. Nerve conduction study was done that showed predominance of sensory neuropathy. The CSF test showed increased protein levels with no pleocytosis. The patient was treated with intravenous methylprednisolone, oral prednisolone, azathioprine, pregabalin, and physiotherapy. Conclusion: The patient demonstrated marked improvement clinically after being treated with immunomodulatory and rehabilitative therapy. The current case report emphasizes that autoimmune neuropathy should be considered in patients with progressing symmetrical sensory deficits. Early diagnosis and prompt treatment play vital roles in averting any neurological impairment among such patients.
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