SHM Converge Scientific Abstract ePoster Gallery-Acute Inflammatory Demyelinating Polyneuropathy Following Bone Marrow Transplant

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This case describes a 69-year-old man with well-controlled type 2 diabetes and multiple myeloma who developed acute inflammatory demyelinating polyneuropathy (AIDP) after a bone marrow transplant (BMT). He had previously received chemotherapy for myeloma, including daratumumab, lenalidomide, bortezomib, and melphalan, and was not on treatment at the time of presentation.<br /><br />After his transplant, he initially returned to normal strength and baseline activity. About one month later, he developed progressive bilateral numbness and weakness in both the upper and lower extremities, without bowel or bladder dysfunction. His symptoms did not improve with gabapentin, duloxetine, or physical therapy, raising concern for more than chemotherapy-induced neuropathy.<br /><br />Further workup supported AIDP. Lumbar puncture showed albumin-cytologic dissociation, with elevated CSF protein and minimal cells. Electromyography demonstrated proximal and distal denervation with demyelinating features. MRI and PET imaging did not show an alternative explanation such as active myeloma.<br /><br />He was treated with intravenous immunoglobulin (IVIG) and improved clinically, supporting the diagnosis.<br /><br />The authors emphasize that AIDP is an immune-mediated polyneuropathy that can rarely occur after BMT, even without graft-versus-host disease. Because it can resemble chemotherapy-related neurotoxicity, it should remain in the differential diagnosis when post-transplant neuropathy is progressive, atypical, or unresponsive to standard treatment. Early recognition is important because untreated AIDP can be serious or fatal, and immunomodulatory therapy such as IVIG or plasmapheresis can be effective.

Asset Subtitle

Sheetal R. Maragiri

Meta Tag

Author List Jeremy J. Gentile, Sheetal R. Maragiri

Category Clinical Vignettes

Concept Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Concept Albumin-Cytologic Dissociation

Concept Demyelination

Concept Intravenous Immunoglobulin

Concept Total Plasma Exchange

Distinguished Non-Finalist

Presenter Organization Corewell Health Grand Rapids

Presenting Author Sheetal R. Maragiri

Track Adult

Keywords

acute inflammatory demyelinating polyneuropathy

AIDP

bone marrow transplant

multiple myeloma

IVIG

demyelinating neuropathy

albumin-cytologic dissociation

chemotherapy-induced neuropathy

electromyography

post-transplant neuropathy

Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Albumin-Cytologic Dissociation

Demyelination

Intravenous Immunoglobulin

Total Plasma Exchange