SHM Converge Scientific Abstract ePoster Gallery-A Case of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP):

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A 57-year-old man presented with 2 months of progressive dysarthria, bilateral arm and leg weakness, and sensory changes. Exam showed distal greater than proximal multimodal sensory loss, impaired vibration, diffuse hyporeflexia, decreased quadriceps bulk, and hammer toes. Basic labs, nutritional studies, heavy metal testing, thyroid studies, and paraneoplastic antibody workup were negative. MRI of the lumbar spine was unrevealing.<br /><br />Lumbar puncture showed clear CSF with opening pressure 120 mmHg, RBC 180/µL, elevated protein (88.7 mg/dL), normal glucose (61 mg/dL), and minimal cells (WBC 1/µL). CSF testing for COVID antibody was positive. EMG demonstrated severe demyelinating length-dependent sensorimotor polyneuropathy.<br /><br />The overall picture was consistent with an inflammatory demyelinating neuropathy, likely in the setting of prior COVID-related immune involvement. The patient was treated with 5 days of IVIG and had remarkable improvement in functional status.<br /><br />This case highlights the importance of considering post-infectious or immune-mediated neuropathy in patients with progressive weakness and sensory loss, especially when CSF shows albuminocytologic dissociation and EMG confirms demyelination.

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Maria Riasat

Meta Tag

Author List Andrea Delgado, Geetika Arora, Karishma Vijay Rupani, Maria Riasat, Mina Shenouda, SVETLANA Chernyavsky, Sreelakshmi Vasudevan

Category Clinical Vignettes

Concept Demyelinating Polyneuropathy

Concept Inflammatory Neuropathy

Concept Sensorimotor Axonal Neuropathy

Concept Cerebrospinal Fluid Protein

Concept Immune-Mediated Neuropathy

Distinguished Non-Finalist

Presenter Organization Mount Sinai Beth Israel

Presenting Author Maria Riasat

Track Adult

Keywords

dysarthria

progressive weakness

sensory loss

demyelinating neuropathy

sensorimotor polyneuropathy

albuminocytologic dissociation

cerebrospinal fluid

COVID-related immune involvement

intravenous immunoglobulin

electromyography

Demyelinating Polyneuropathy

Inflammatory Neuropathy

Sensorimotor Axonal Neuropathy

Cerebrospinal Fluid Protein

Immune-Mediated Neuropathy