title: Chronic inflammatory demyelinating polyradiculoneuropathy with autonomic involvement.
abstract: We report a case of chronic acquired neuropathy predominantly affecting sensory and autonomic nerves. Investigations showed a demyelinating polyradiculoneuropathy with axonal degeneration and depletion of postganglionic noradrenergic fibers in the rectal mucosa. Intravenous immunoglobulin and corticosteroid administration were effective in alleviating symptoms and improving electrophysiological abnormalities. This neuropathy may be a novel variant of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), in which autoimmunoreactivity is directed not only against myelin but also against axon- or ganglion-composing protein. Autonomic nerve involvement does not exclude a diagnosis of CIDP.
authors.affiliation: Third Department of Medicine, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan. kanji_yamamoto@hospital.nagano.nagano.jp <kanji_yamamoto@hospital.nagano.nagano.jp>
authors.forename: Kanji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Megumi
authors.initials: M
authors.lastname: Watarai
authors.forename: Takao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Ikeda
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000473:pathology* / Q000503:physiopathology*; D001706:Biopsy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009431:Neural Conduction; D009475:Neurons, Afferent / Q000502:physiology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000473:pathology* / Q000503:physiopathology*; D013497:Sural Nerve / Q000473:pathology