title: Chronic inflammatory demyelinating polyneuropathy associated with primary biliary cirrhosis.
abstract: We report a patient with chronic inflammatory demyelinating polyneuropathy associated with primary biliary cirrhosis (PBC). Except for minimal biochemical abnormalities, clinical symptoms of PBC were not observed, and we diagnosed our patient with asymptomatic PBC from the results of a liver biopsy. Although the patient noticed little muscle weakness, an electrophysiological study demonstrated slow conduction velocities and prolonged distal latencies, with definite conduction blocks in the median, ulnar, and tibial nerves. The disturbed sensory pattern was asymmetrical, and sensory nerve action potentials were not evoked. From these observations, we diagnosed this patient with chronic inflammatory demyelinating polyneuropathy. Neuropathy associated with PBC is very rare. We must differentiate demyelinating neuropathy with PBC in patients with asymmetrical sensory dominant neuropathy with high immunoglobulin M titers, and investigate for the presence of anti-mitochondrial antibodies to rule out a complication of asymptomatic PBC.
authors.affiliation: Department of Neurology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8510, Japan. Electronic address: kemurata@wakayama-med.ac.jp.
authors.forename: Ken-ya
authors.initials: KY
authors.lastname: Murata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishiguchi
authors.forename: Ryuki
authors.initials: R
authors.lastname: Ando
authors.forename: Hideto
authors.initials: H
authors.lastname: Miwa
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000328:Adult; D003711:Demyelinating Diseases / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000503:physiopathology; D009431:Neural Conduction / Q000502:physiology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000150:complications* / Q000503:physiopathology; D013979:Tibial Nerve / Q000503:physiopathology*; D014459:Ulnar Nerve / Q000503:physiopathology*
keywords: Anti-mitochondrial M2 antibody; Chronic inflammatory demyelinating polyneuropathy; Liver biopsy; Primary biliary cirrhosis