Shah Akshay, Rison Richard A, Beydoun Said R
*Neuromuscular Division, Department of Neurology, Keck Medical Center of USC, University of Southern California, Los Angeles, CA; and †Neurology Consultants Medical Group, Keck School of Medicine, University of Southern California, Los Angeles County Medical Center, Medical Director PIH Health Stroke Program, Whittier, CA.
J Clin Neuromuscul Dis. 2015 Dec;17(2):78-83. doi: 10.1097/CND.0000000000000094.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a progressive demyelinating neuropathy, which typically presents with proximal and distal neuropathic symptoms and is typically responsive to immunomodulatory therapies. Many variants have been subsequently described in the literature and have similarly shown to be responsive to immunotherapy.
We present a case of a 43-year-old Middle Eastern/Arabic man presenting with symptoms of mixed sensorimotor neuropathy most evident at entrapment sites mimicking hereditary neuropathy with liability to pressure palsies. His electrodiagnostic study revealed features of acquired demyelinating neuropathy and a negative genetic workup. Alternative diagnosis of CIDP was considered in the context of symptomatic disease progression, negative genetic workup, and electrodiagnosis leading to initiation of immunotherapy with intravenous immunoglobulins. His neuropathy responded confirming our diagnosis of an inflammatory demyelinating polyneuropathy.
We describe a previously unknown variant of CIDP with phenotypic characteristics of hereditary neuropathy with liability to pressure palsies and its potential for successful treatment with intravenous immunoglobulins. This case illustrates an unusual presentation of CIDP mimicking hereditary neuropathy with liability to pressure palsies.
慢性炎症性脱髓鞘性多发性神经病(CIDP)是一种进行性脱髓鞘性神经病,通常表现为近端和远端神经病变症状,并且通常对免疫调节疗法有反应。随后文献中描述了许多变体,同样显示对免疫疗法有反应。
我们报告一例43岁中东/阿拉伯男性病例,其表现为混合性感觉运动神经病症状,在卡压部位最为明显,类似遗传性压力易感性麻痹性神经病。他的电诊断研究显示获得性脱髓鞘性神经病的特征,基因检查结果为阴性。鉴于症状性疾病进展、基因检查结果阴性以及电诊断结果,考虑CIDP的其他诊断,并开始使用静脉注射免疫球蛋白进行免疫治疗。他的神经病症状得到缓解,证实了我们对炎症性脱髓鞘性多发性神经病的诊断。
我们描述了一种先前未知的CIDP变体,具有遗传性压力易感性麻痹性神经病的表型特征,并且有通过静脉注射免疫球蛋白成功治疗的可能性。该病例说明了CIDP模仿遗传性压力易感性麻痹性神经病的不寻常表现。