Year :
2021
| Month :
April
| Volume :
15
| Issue :
4
| Page :
OD10 - OD11
Full Version
Monoclonal Gammopathy Presenting as Peripheral Neuropathy
Published: April 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/47090.14800
Vishaka Agarwal, Koukutla Soundarya Rajeshwari, KT Jayakumar, Satish, Chetan Somu
1. Postgraduate Student, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
2. Postgraduate Student, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
3. Professor, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
4. Resident, Department of Neurology, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
5. Senior Resident, Department of Internal Medicine, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
Correspondence Address :
Dr. Vishaka Agarwal,
Flat No. 3133, Tower 3, Estancia Towers, Guduvanc Hery, Chennai, Tamil Nadu, India.
E-mail: vishaka.532494@gmail.com
Abstract
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a 40-year-old male patient who presented with complaints of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis, immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of CIDP and its underlying cause.
Keywords
Chronic inflammatory demyelinating polyradiculoneuropathy, Electrodiagnosis, Plasma cell dyscrasia
10.7860/JCDR/2021/47090.14800
Date of Submission: Oct 13, 2020
Date of Peer Review: Dec 23, 2020
Date of Acceptance: Jan 13, 2021
Date of Publishing: Apr 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 14, 2020
• Manual Googling: Jan 13, 2021
• iThenticate Software: Feb 03, 2021 (9%)
ETYMOLOGY: Author Origin
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