{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:02:24Z","timestamp":1789797744710,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":260,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Guillain\u2010Barr\u00e9 syndrome (GBS) is an acute autoimmune polyradiculoneuropathy typically characterized by an ascending sensorimotor deficit with potential involvement of bulbar and respiratory muscles that may necessitate intensive care admission and mechanical ventilation. Standard treatment includes supportive care, management of complications such as weakness, immobility, respiratory failure, autonomic dysfunction and pain, along with early initiation of immunotherapy\u2014either intravenous immunoglobulin (IVIg) or plasma exchange (PE). However, lack of significant clinical improvement following immunotherapy should prompt consideration of alternative diagnoses, including pan\u2010neurofascin antibody\u2010positive autoimmune nodopathy (panNF + AN). In this report, we present two patients presenting with a severe GBS\u2010like neuropathy. Initial treatment with IVIg resulted in either no response or only transient, mild improvement, followed by rapid clinical deterioration to near\u2010complete tetraplegia, respiratory failure, and autonomic and cranial nerve involvement. Both patients were unresponsive to further treatment with a second course of IVIg, PE and corticosteroids. Subsequent diagnostic evaluation revealed the presence of pan\u2010neurofascin antibodies, confirming panNF + AN. This prompted initiation of treatment with rituximab, which resulted in sustained and complete clinical recovery in both cases. A transient or mild clinical response\u2014or an initial lack of response\u2014to standard GBS\u2010treatment followed by rapid and severe deterioration in cases initially presenting as GBS should be considered a red flag warranting evaluation for AN\u2010associated antibodies. Recognition of this important GBS mimic is critical, as it requires an alternative treatment approach with rituximab, which has been associated excellent clinical outcomes.<\/jats:p>","DOI":"10.1155\/crcc\/2662185","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T05:22:50Z","timestamp":1789795370000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pan\u2010Neurofascin Antibody\u2010Associated Nodopathy: A Critical Guillain\u2013Barr\u00e9 Syndrome Mimic in the Differential Diagnosis\u2014Report of Two Cases"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0914-5103","authenticated-orcid":false,"given":"Andrea","family":"Nemethova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"De Ridder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7760-3366","authenticated-orcid":false,"given":"Ingrid","family":"Baar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-9255","authenticated-orcid":false,"given":"Alicia","family":"Alonso-Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16073"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2013.03.025"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-317968"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6806-x"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.12.2311"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.121"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy134"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000603"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2021-326343"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15266"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12111587"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-023-07297-4"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000041304"},{"key":"e_1_2_9_14_2","article-title":"Pan-Neurofascin Autoimmune Nodopathy - 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