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Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 59
Author(s) -
Suozzi R,
Galassi G,
Ariatti A
Publication year - 2003
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2003.00059.x
Subject(s) - medicine , polyradiculoneuropathy , peripheral neuropathy , paresis , weakness , cranial nerves , cancer , gastroenterology , surgery , diabetes mellitus , guillain barre syndrome , pediatrics , endocrinology
A wide range of axonal peripheral neuropathies, especially subacute sensory and motor neuronopathies have been reported as remote effect of cancer. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) most often occurs isolated but it may accompany several autoimmune diseases. The association of CIDP and carcinoma is rare and its relevance is still debated. Few cases have been associated with gastrointestinal cancers. This 53‐year old man was admitted in December 1989 because of severe extremity weakness after EBV infection. Neurologic examination showed facial paresis, proximal and distal limb weakness, areflexia, distal loss for touch and deep sensibilities. Patient recovered with PE but mild symptoms and signs persisted in the limbs. In June 1997, patient developed acute relapse of his neuropathy after an episode of pneumonia. Electrophysiology, CSF and nerve biopsy were consistent with CIDP. Search for anti‐nerve antibodies was negative except for anti‐neurofilament IgM. IVIG had partial benefit. During the following four years, patient received IVIG 1 g/Kg monthly; however he continued to experience relapses of the neuropathy often occurring after trivial infections. Laboratory tests (monoclonal IgG; elevated SR and WB count, serum electrophoresis, carcinoembryonic antigen titer) suggested a systemic disease. In September 2001 a rectosigmoidal adenocarcinoma with bladder and liver metastases was discovered on abdominal CT scan and surgically treated. Patient's general and neurologic conditions rapidly deteriorated despite of chemotherapy with fluorouracil and leucovorin. He died on late summer 2002. We outline the unusual association of CIDP and intestinal cancer and the long interval elapsed between neuropathy onset and cancer detection.