Yasuda Ken, Murase Nagako, Ohtani Ryo, Oka Nobuyuki, Nakamura Michikazu
Department of Neurology, National Hospital Organization Kyoto Medical Center.
Present Address: Department of Neurology, Kyoto University, Graduate School of Medicine.
Rinsho Shinkeigaku. 2018 Jan 26;58(1):21-24. doi: 10.5692/clinicalneurol.cn-001073. Epub 2017 Dec 22.
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.
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。