There are few case reports of concomitant chronic inflammatory demyelinating polyneuropathy (CIDP) and focal segmental glomerulosclerosis. A rare autoantibody to a neuronal and podocyte structural component, neurofascin, may be contributory. A Black man in his 40s presented with worsening polyneuropathy requiring mechanical ventilation and initially acute inflammatory demyelinating polyneuropathy was diagnosed. After a poor response to intravenous immunoglobulin, plasmapheresis was initiated. The patient also had concomitant new-onset nephrotic-range proteinuria. A limited kidney biopsy was interpreted as minimal change disease and was treated with prednisone. After some improvement, the patient was extubated; however, he later re-presented with worsening symptoms requiring mechanical ventilation and was re-treated with plasmapheresis. Due to the protracted course and poor response to intravenous immunoglobulin, acute-onset CIDP was diagnosed and a neuromuscular antibody workup returned positive for neurofascin, supporting the diagnosis of seropositive acute-onset CIDP. A repeat kidney biopsy demonstrated focal segmental glomerulosclerosis and acute tubular damage. The patient was treated with steroids and tacrolimus and later transitioned to rituximab. Neurofascin enzyme-linked immunosorbent assay then tested negative with concomitant resolution of both neuropathy and proteinuria. Further studies will help validate these findings and the treatment strategy.

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The study was conducted on 80 male children, divided into three age groups (5-7, 8-10 and 11-12 years). These children were graded into five grades of malnutrition including normal following the criteria of Jelliffe (Alleyne et al., 1977). The results revealed 47.22 per cent normal children while 16.66, 22.22, 11,11 and 2.77 percent were suffering from 1st, 2nd 3rd and 4th degree of malnutrition, respectively. Overall means of children categorized in various degrees of malnutrition showed non-significant difference in haemoglobin, RBC, PCV and erythrocytic indices. However, RBC, Hb and PCV value were less in children graded in 4th degree of malnutrition. Hb showed significantly lower (p<0.05) levels in children grade into 3rd than first degree of malnutrition of 8-10 years. However, RBC count was significantly higher (p<0.05) in 3rd and 2nd degree of malnutrition in children of 11-12 years, while PCV was relatively higher in the same subjects of this group. In overall, 45 percent of children had less than normal haemoglobin, RBC or both. Out of these, 19.44 percent showed normocytic hypochromic, 30.55 showed normocytic normochromic, 8.33 microcytic hypochromic, 13.88 microcytic normochromic, 13.88 macrocytic hypochromic and 13.88 percent showed macrocytic normochromic anaemia. Serum to proteins showed non-significant difference in children graded in various degrees of malnutrition, however, the values normal subjects were relatively lower than those graded into various degrees of malnutrition.

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