Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and ma...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-04-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/14800/47090_CE[Ra1]_F[SK]_PF1(AG_KM)_PFA(SL)_PB(AG_KM)_PN(KM).pdf |
| _version_ | 1819103892103757824 |
|---|---|
| author | Vishaka Agarwal Koukutla Soundarya Rajeshwari KT Jayakumar Satish Chetan Somu |
| author_facet | Vishaka Agarwal Koukutla Soundarya Rajeshwari KT Jayakumar Satish Chetan Somu |
| author_sort | Vishaka Agarwal |
| collection | DOAJ |
| description | Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long
duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations,
autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a 40-year-old male patient who presented
with complaints of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which
was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left
anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally
and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar
being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension
were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of
his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis,
immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised
for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a
challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of
CIDP and its underlying cause. |
| first_indexed | 2024-12-22T01:57:40Z |
| format | Article |
| id | doaj.art-f269df8531bd4ea2854bca0bff7a836e |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-22T01:57:40Z |
| publishDate | 2021-04-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-f269df8531bd4ea2854bca0bff7a836e2022-12-21T18:42:44ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-04-01154OD10OD1110.7860/JCDR/2021/47090.14800Monoclonal Gammopathy Presenting Section as Peripheral NeuropathyVishaka Agarwal0Koukutla Soundarya Rajeshwari1KT Jayakumar2Satish3Chetan Somu4Postgraduate Student, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Postgraduate Student, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Professor, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Resident, Department of Neurology, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Senior Resident, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a 40-year-old male patient who presented with complaints of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis, immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of CIDP and its underlying cause.https://www.jcdr.net/articles/PDF/14800/47090_CE[Ra1]_F[SK]_PF1(AG_KM)_PFA(SL)_PB(AG_KM)_PN(KM).pdfchronic inflammatory demyelinating polyradiculoneuropathyelectrodiagnosisplasma cell dyscrasia |
| spellingShingle | Vishaka Agarwal Koukutla Soundarya Rajeshwari KT Jayakumar Satish Chetan Somu Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy Journal of Clinical and Diagnostic Research chronic inflammatory demyelinating polyradiculoneuropathy electrodiagnosis plasma cell dyscrasia |
| title | Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy |
| title_full | Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy |
| title_fullStr | Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy |
| title_full_unstemmed | Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy |
| title_short | Monoclonal Gammopathy Presenting Section as Peripheral Neuropathy |
| title_sort | monoclonal gammopathy presenting section as peripheral neuropathy |
| topic | chronic inflammatory demyelinating polyradiculoneuropathy electrodiagnosis plasma cell dyscrasia |
| url | https://www.jcdr.net/articles/PDF/14800/47090_CE[Ra1]_F[SK]_PF1(AG_KM)_PFA(SL)_PB(AG_KM)_PN(KM).pdf |
| work_keys_str_mv | AT vishakaagarwal monoclonalgammopathypresentingsectionasperipheralneuropathy AT koukutlasoundaryarajeshwari monoclonalgammopathypresentingsectionasperipheralneuropathy AT ktjayakumar monoclonalgammopathypresentingsectionasperipheralneuropathy AT satish monoclonalgammopathypresentingsectionasperipheralneuropathy AT chetansomu monoclonalgammopathypresentingsectionasperipheralneuropathy |