Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Diabetes: A Case Report

Area of Science:

• Neurology
• Immunology
• Diabetology

Background:

• Diabetic neuropathy is common, but differentiating it from other neuropathies like CIDP is critical.
• Poorly controlled diabetes can exacerbate or mimic other neurological conditions.
• Accurate diagnosis is essential for effective treatment and improved patient outcomes.

Observation:

• A 42-year-old female with poorly controlled diabetes presented with progressive neurological deficits including ataxic gait and limb dysfunction.
• Cerebrospinal fluid analysis revealed elevated protein levels, while initial electrophysiologic studies suggested distal symmetric polyneuropathy (DSPN).
• Subsequent nerve conduction studies confirmed a diagnosis of chronic inflammatory demyelinating polyneuroradiculopathy (CIDP).

Findings:

• Intravenous immunoglobulin (IVIg) initially improved neurological scores (INCAT and MRC Sum Score).
• Symptoms recurred, necessitating corticosteroids, which complicated diabetes management.
• Treatment was further complicated by nephrotic syndrome, leading to IVIg discontinuation and initiation of immunosuppression.

Implications:

• This case highlights the diagnostic challenge in differentiating CIDP from diabetic neuropathy.
• Prompt diagnosis and initiation of appropriate therapy for CIDP are vital to prevent irreversible sequelae.
• Close monitoring of diabetic patients with neuropathy is essential for timely and accurate diagnosis and management.