title: Acute-onset chronic inflammatory demyelinating polyneuropathy in hantavirus and hepatitis B virus coinfection: A case report.
abstract: BACKGROUND
  Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune disorder with progressive weakness. Acute-onset CIDP resembles Guillain-Barre syndrome (GBS), a rapidly progressive disorder, and follows a chronic course. To our knowledge, no case of acute-onset CIDP in hantavirus and hepatitis B virus (HBV) coinfection has been reported previously.
  
  
  RESULTS
  We report a case of acute-onset CIDP that was initially diagnosed as GBS.
  
  
  METHODS
  A 44-year-old male logger complained of acute quadriplegia and dyspnea. Mechanical ventilation was initiated. He was an HBV carrier with mild elevation of hepatic enzyme, and positive for hantavirus antibody. He was diagnosed with GBS and immunoglobulin therapy was administered.
  
  
  METHODS
  After 8 months, quadriplegia and hypesthesia recurred. Immunoglobulin therapy at this time had no effect, but steroid therapy had some effect.
  
  
  RESULTS
  A diagnosis of CIDP was made. After 2 months, severe extremity pain and dyspnea developed again, and steroid pulse therapy was initiated.
  
  
  CONCLUSIONS
  Besides GBS, acute-onset CIDP can occur with hantavirus and HBV coinfection. Patients with this coinfection in whom GBS has been initially diagnosed should be followed up for a long time, because of the possibility of relapse or deterioration, and acute-onset CIDP should always be considered.
authors.affiliation: Department of Rehabilitation Medicine, Eulji University Hospital, Daejeon Department of Rehabilitation Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, South Korea.
authors.forename: Jong Youb
authors.initials: JY
authors.lastname: Lim
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Lim
authors.forename: Eun-Hi
authors.initials: EH
authors.lastname: Choi
mesh_terms: D000208:Acute Disease; D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage*; D002353:Carrier State; D060085:Coinfection / Q000175:diagnosis / Q000628:therapy; D005081:Exercise Therapy / Q000379:methods; D005500:Follow-Up Studies; D018778:Hantavirus Infections / Q000150:complications* / Q000175:diagnosis; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D008297:Male; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011239:Prednisolone / Q000008:administration & dosage*; D011379:Prognosis; D012008:Recurrence; D019233:Retreatment; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D007136:Immunoglobulins; D011239:Prednisolone; D001379:Azathioprine