Incomplete intestinal obstruction as an initial and persistent presentation in chronic inflammatory demyelinating...

Area of Science:

• Neurology
• Gastroenterology

Background:

• Autonomic symptoms are common in Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) but usually mild.
• Severe autonomic dysfunction, like intestinal obstruction, is an atypical presentation of CIDP.

Observation:

• A patient presented with persistent, incomplete intestinal obstruction as the primary symptom.
• Clinical features included chronic abdominal pain, distension, constipation, followed by limb numbness and weakness.

Findings:

• Diagnostic workup revealed incomplete intestinal obstruction, albuminocytological dissociation in cerebrospinal fluid (CSF), and neurogenic lesions on electromyography (EMG).
• The patient was diagnosed with CIDP manifesting as severe gastrointestinal dysmotility.

Implications:

• This case underscores the importance of considering CIDP in unexplained intestinal obstruction.
• CSF analysis and EMG are crucial for diagnosing rare CIDP presentations involving autonomic dysfunction.