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 2 The patient’s serum laboratory values from 2 years later, at her second admission.
| Test | Value | Reference range and unit |
|---|---|---|
| Sedimentation rate | 20 | 0–20 mm/h |
| Prothrombin time | 13.9 | 11–15.6 s |
| International normalized ratio | 1.1 | TR=2.0–3.0 |
| Free thyroxine (T4) | 1.5 | 0.9–2.1 ng/dL |
| Thyroid-stimulating hormone (TSH) | 1.30 | 0.27–4.20 uIU/mL |
| Total triiodothyronine (T3) | 41 | 80–200 ng/dL |
| Calcium, ionized | 1.21 | 1.05–1.35 mmol/L |
| Fibrinogen | 141 | 200–400 mg/dL |
| Phosphorus | 3.4 | 2.5–4.5 mg/dL |
| Vitamin B12 | 465 | 211–946 pg/mL |
| Folate | 16.3 | >3.1 ng/mL |
| Methylmalonic acid | 158 | 87–318 nmol/L |
| Homocysteine | 9.0 | <15.0 umol/L |
| Neuromyelitis optica/aquaporin-4 (NMO/AQP4) Titer | >1: 100000 | <1: 5 |
| Myasthenia gravis panel | Acetylcholine binding immunoglobulin: 4.98Striated muscle antibody reflex titer: negative | ≤0.30 nmol/LNegative |