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Horiuchi M, Hongo Y, Yamazaki K, Komuta Y, Kadoya M, Takazaki H, Furuya Y, Matsui T, Sakamoto N, Ikewaki K, Suzuki K, Kaida K. An Atypical Phenotype of Chronic Inflammatory Demyelinating Polyradiculoneuropathy Associated with Ocular Palsy, IgM-anti Ganglioside Antibody, and Fever-induced Recurrence. Intern Med 2022; 61:1247-1252. [PMID: 34615817 PMCID: PMC9107973 DOI: 10.2169/internalmedicine.7526-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022] Open
Abstract
We herein report a case of recurrent multifocal, distal-dominant-sensorimotor neuropathy with ophthalmoplegia, IgM anti-GM1 antibody, and pyrexia-associated relapse. The patient developed sensory disturbance in her limbs after febrile disease at 50 years old. She had experienced several similar episodes and was admitted to the hospital at 56 years old. Based on a pathological study and electrophysiological findings consistent with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), maintenance IVIg therapy was administered and produced partial improvement with no relapse at one-year follow-up. Immunohistochemical studies suggested the presence of IgG (not IgM) anti-myelin antibodies. Chronic neuropathy with ophthalmoplegia and pyrexia-associated relapse may be a unique variant of CIDP.
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Affiliation(s)
- Midori Horiuchi
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
- Department of Internal Medicine, Self-Defense Forces Central Hospital, Japan
| | - Yu Hongo
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Keishi Yamazaki
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Yukari Komuta
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Masato Kadoya
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Hiroshi Takazaki
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Yuichiro Furuya
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Taro Matsui
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Naohiro Sakamoto
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Katsunori Ikewaki
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Kazushi Suzuki
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
| | - Kenichi Kaida
- Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Japan
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Japan
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Tsukamoto H, Sonoo M, Shimizu T. Segmental evaluation of the peripheral nerve using tibial nerve SEPs for the diagnosis of CIDP. Clin Neurophysiol 2010; 121:77-84. [DOI: 10.1016/j.clinph.2009.09.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Revised: 08/21/2009] [Accepted: 09/17/2009] [Indexed: 11/28/2022]
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