Medical case narrative
A 16-year-old whose spinal fluid named a rarer antibody
What happened
A 16-year-old girl became so unwell that on day 8 of her illness, psychiatry recommended transfer to an inpatient psychiatric unit. She was never actually admitted to psychiatry — her autonomic instability (her body's automatic systems swinging out of control) kept her on the medical side.
What it looked like
A psychiatric presentation severe enough for an inpatient recommendation, alongside a body that clearly wasn't stable.
What the labs found
On day 18, her spinal fluid came back positive for anti-NIF antibodies (1:16) — a rarer autoimmune marker attacking structures inside nerve cells.
What changed
She received IV steroids, IVIG, rituximab, and five sessions of plasmapheresis, and was discharged on day 57. More than a year later, her symptoms were still reported resolved and her psychiatric medications had been discontinued — though she remained on immune-modulating treatment.
The test that told the story
CSF autoimmune antibody panel (anti-NIF).
Sources: Case report via CPCEM / eScholarship; Medical Daily coverage of the same case.