Inflammatory demyelinating neuropathy heralding accelerated chediak-higashi syndrome.
Chediak-Higashi syndrome (CHS) is a very rare autosomal recessive disorder (gene CHS1/LYST) characterized by partial albinism, recurrent infections, and easy bruising. Survivors develop a constellation of slowly progressive neurological manifestations.



We describe clinical, laboratory, electrophysiological, and genetic findings of a patient who developed an immune-mediated demyelinating neuropathy as the main clinical feature of CHS.



The patient presented with subacute flaccid paraparesis, absent reflexes, and reduced vibration sense. Protein and immunoglobulins (Igs) were elevated in the cerebrospinal fluid. Electrodiagnostic tests indicated an acquired chronic demyelinating polyneuropathy. Intravenous Ig and immunosuppressant treatment resulted in neurological improvement. The patient later developed organomegaly and pancytopenia. Bone-marrow smear revealed giant azurophilic granules pathognomonic for CHS. Two novel mutations in the LYST gene were identified through whole exome sequencing [c.7786C>T and c.9106 + 1G>T].



This case expands the clinical phenotype of CHS and highlights inflammatory demyelinating neuropathy as a manifestation of the disease. Muscle Nerve 55: 756-760, 2017.
Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo,126. Cidade Universitaria "Zeferino Vaz", Campinas, SP, Brazil.
Ingrid Vasconcellos
IV
Faber
Department of Medical Genetics, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil.
Joana Rosa Marques
JRM
Prota
Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo,126. Cidade Universitaria "Zeferino Vaz", Campinas, SP, Brazil.
Alberto Rolim Muro
ARM
Martinez
Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo,126. Cidade Universitaria "Zeferino Vaz", Campinas, SP, Brazil.
Anamarli
A
Nucci
Department of Medical Genetics, School of Medical Sciences, University of Campinas - UNICAMP, Campinas, SP, Brazil.
Iscia
I
Lopes-Cendes
Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo,126. Cidade Universitaria "Zeferino Vaz", Campinas, SP, Brazil.
Marcondes Cavalcante França
MCF
Júnior
D000293:Adolescent; D002609:Chediak-Higashi Syndrome / Q000150:complications* / Q000235:genetics / Q000503:physiopathology; D018450:Disease Progression; D004568:Electrodiagnosis; D005260:Female; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D009154:Mutation; D033921:Vesicular Transport Proteins / Q000235:genetics
C102161:LYST protein, human; D033921:Vesicular Transport Proteins
Chediak-Higashi syndrome; albinism; chronic inflammatory polyneuropathy; demyelinating neuropathy; immunodeficiency; lysosomal disorder