27 July 2025
: Case report 
One Patient with 3 Antibody-Confirmed Neurological Autoimmune Syndromes: A Case Report and Review of the Literature
Challenging differential diagnosis, Management of emergency care, Clinical situation which can not be reproduced for ethical reasons, Rare coexistence of disease or pathology
Lauren A. Nguyen ABCDEF 1*, Frishan Rocel O. Paulo ABCDF 1, Jordan J. Petersen ABCDE 1, J. Douglas Miles
AEFG 1
DOI: 10.12659/AJCR.948329
Am J Case Rep 2025; 26:e948329
Table 1 The patient’s initial serum laboratory values.
| Test | Initial value | Reference range and unit |
|---|---|---|
| Neuromyelitis optica/aquaporin-4 IgG | Positive | Negative |
| Factor V Leiden mutation | Not detected | Not detected |
| Anti-nuclear antibody | 40 | ≤40 |
| Anti-neutrophil cytoplasmic antibody | Positive | Negative |
| Complement component 3 (C3) (beta immunoglobulin complex/A) | 76 | 90–180 mg/dL |
| Complement component 4 (C4) | 14 | 10–40 mg/dL |
| Total complement activity (CH-50) | 153 | 101–300 CH50 value |
| Antistreptolysin O | 278 | ≤200 IU/mL |
| Lupus anticoagulant screen | Prothrombin time (PT): 14.2Activated partial thromboplastin time (PTT): 31.3Lupus anticoagulant screen (dilute Russell’s viper venom time (DRVVT)): 28.6Lupus anticoagulant interpretation: normal | PT: 11–15.6 sPTT: 24–40 sLA Screen: <49.5 sLA interpretation: normal |
| Antithrombin III | 83 | 80–120% |
| Protein C resistance, activated | 4.5 | >2.1 ratio |
| Prothrombin G20210A mutation | Not detected | Not detected |
| Cardiolipin antibody screen, IgG and IgM | Negative | Negative |
| Antineutrophil cytoplasmic antibody titer and pattern, indirect fluorescent antibody test | 1: 20 H, P-ANCA | <1: 20 |
| Rapid plasma region | Non-reactive | Non-reactive |
| HIV 1/2 by enzyme-linked immunosorbent assay) | Negative | Negative |