CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Combined Central and Peripheral Nerve Demyelination with Neurofilament Heavy Chain Antibodies
Provisionally accepted
Xue-Lu Zhao1Ze-Yu Zhao2
Chun-Lin Yang2Min Zhang2Hua Xu2
Guan-Qing Wang2Ying Liu2Yan-Bin Li2
Rui-sheng Duan2
Xiao-Li Li2*- 1Shandong Provincial Third Hospital, Jinan, China
- 2Shandong Provincial Qianfoshan Hospital, Jinan, China
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Abstract Combined central and peripheral demyelination (CCPD) is a rare chronic demyelinating disorder. Neurofilament (NF) proteins are structural components specific to neuronal intermediate filaments within axons. The presence of anti-neurofilament antibodies is typically associated with axonal pathology and is seldom observed in patients with CCPD. We present a case of CCPD in a patient who tested positive for immunoglobulin G (IgG) antibodies against the neurofilament heavy chain (NF-H-IgG) in both cerebrospinal fluid (CSF) and serum. Since 2019, the patient has exhibited a constellation of neurological symptoms, including severe neck and shoulder pain, left-sided limb weakness, distal extremity numbness, left-eye visual blurring, and impaired deep sensation. Electrophysiological and clinical evaluations indicated a primarily demyelinating peripheral neuropathy with secondary axonal involvement. Following treatment with low-dose corticosteroids in combination with cyclophosphamide (CTX), the patient demonstrated marked clinical improvement.
Keywords: Chronic inflammatory demyelinating polyradiculoneuropathy, combined central nervous system and peripheral nervous system demyelination, Immunotherapy, neurofilament heavy chain antibodies, Neurofilament protein
Received: 29 Oct 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Zhao, Zhao, Yang, Zhang, Xu, Wang, Liu, Li, Duan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiao-Li Li
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