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[一例慢性炎性脱髓鞘性多发性神经根神经病,显示在20年间隔后因脊髓神经根和神经丛的结节性肥大出现根性疼痛,且无复发的感觉运动症状]

[A case of chronic inflammatory demyelinating polyradiculoneuropathy, showing radicular pain due to tuberous hypertrophy of the spinal roots and plexuses after 20 years interval without relapsing sensorimotor symptoms].

作者信息

Yasuda Ken, Murase Nagako, Ohtani Ryo, Oka Nobuyuki, Nakamura Michikazu

机构信息

Department of Neurology, National Hospital Organization Kyoto Medical Center.

Present Address: Department of Neurology, Kyoto University, Graduate School of Medicine.

出版信息

Rinsho Shinkeigaku. 2018 Jan 26;58(1):21-24. doi: 10.5692/clinicalneurol.cn-001073. Epub 2017 Dec 22.

Abstract

A 40-year-old man visited our department because of chest and back pain. He had a history of diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) 20 years ago. He received immunosuppressive therapy and had no relapses after that. On Admission, MRI showed tuberous hypertrophy of the spinal roots, intercostal nerves, and brachial and lumbar plexuses. The genetic analysis showed no mutations in any of Charcot-Marie-Tooth related genes. He was finally diagnosed with CIDP and administration of high dose intravenous methylprednisolone relieved his chest and back pain within a few days. We present a rare case of CIDP in which showed marked enlarged spinal roots in long clinical course and have a relapse with radicular pain without sensorimotor symptoms.

摘要

一名40岁男性因胸痛和背痛前来我院就诊。他20年前被诊断为慢性炎症性脱髓鞘性多发性神经病(CIDP)。他接受了免疫抑制治疗,此后未再复发。入院时,MRI显示脊神经根、肋间神经以及臂丛和腰丛呈结节状肥大。基因分析显示在任何与夏科-马里-图斯病相关的基因中均无突变。他最终被诊断为CIDP,给予大剂量静脉注射甲基强的松龙后,数天内胸痛和背痛得到缓解。我们报告了一例罕见的CIDP病例,该病例在漫长的临床病程中显示脊神经根明显增粗,且出现了伴有神经根性疼痛但无感觉运动症状的复发情况。

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