I'm confused by (read: confined to) an open state of mind:
To be a narcissistic misanthrope, and for it to cause any issue.
Surely in its true entirety there cannot be a problem. The problem comes from being aware of other opinions, and wanting to fit in or be recognised. Which objectifies your belief in being self-loving, egotistical and also, in mistrusting other persons. With a hatred possibly growing given further thought to those around.
Proof a misanthrope is also [naturally] a narcissist:
In a line of ideas then- To have such distaste, mistrust; At times overwhelming contempt. One might perhaps view themselves as an opposite. As the class of misanthrope does not necessitate self-loathing. In such cases, to be greater than your other worldly men, you cannot deny a certain self-belief, conceit, vanity.
To paraphrase Aristotle: 'the misanthrope, as an essentially solitary man, is not a man at all: he must be a beast or a god.'
beast of a god :: god of beasts
Back to how I began, on being a narcissistic misanthrope and it possibly causing issue. I change this to 'A misanthrope is to have no troubles with oneself: Easier living.' Unless one misanthrope is also ostentatious.
It would just be the outside other's need to prevail, introduce the image of superiority in their own mind. An ambition not to be slighted, it should be noted!
Of an ostentatious misanthrope:
Where might there lay a true romantic. Surely not caught inside a self inflicted barrier of generalised disgust at humankind?