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Multiple Mononeuropathy

Multiple mononeuropathy
This 25-year-old patient presented with clinical features of mononeuropathy multiplex (multifocal neuropathy). Serologic studies showed normal inflammatory markers. The nerve biopsy was performed to evaluate for vasculitis. The patient was treated with steroids prior to biopsy.   Based on the following images (see Figures 1 – 5) what additional testing would be most warranted? A. ANCA B. Del/Dup PMP22 C. Amyloid subtyping D. Hemoglobin A1C   Note the two axons that appear enlarged (thick arrows) compared to other myelinated axons within the nerve fascicle   Note the several axons have thicker myelin sheaths (thick arrows) compared to other large-diameter myelinated...