A 26-year-old woman comes to the physician because of an 8-day history of difficulty swallowing, shortness of breath, and progressive weakness of her legs; she also has a 2-day history of tingling of her legs. She had an episode of diarrhea 1 month ago. Physical examination shows decreased deep tendon reflexes in the upper extremities and absent deep tendon reflexes in the lower extremities. A lumbar puncture is performed. Cerebrospinal fluid analysis shows a cell count of 4/mm3 and protein concentration of 65 mg/dL. If a peripheral nerve biopsy specimen were obtained, histologic examination would most likely show which of the following findings? A) Endoneurial lymphocytic infiltrates and destruction of myelin B) Endoneurial neutrophilic infiltrates and destruction of connective tissue C) Perineurial lymphocytic infiltrates and vascular thrombosis D) Perineural Neutrophilic infiltrates and destruction of axons E) Perineurial neutrophilic infiltrates and vascular necrosis
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Step 1: The patient presents with difficulty swallowing, shortness of breath, progressive weakness of her legs, and tingling of her legs, which are indicative of a neurological condition affecting the peripheral nervous system. Show more…
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