Chronic Inflammatory Demyelinating Polyneuropathy Presenting With Isolated Distal Fingertip Paresthesia in a Factory...

Peripheral neuropathy (PN) is an underrecognized extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC). We report a case of a 52-year-old male patient with UC and type 2 diabetes mellitus who developed progressive weakness and sensory disturbances localized to the fingertips of both hands over approximately one year. Initial evaluation by occupational health services did not identify any occupational cause, and subsequent public health assessments yielded no further explanation. Upon presentation to our clinic, examination revealed diminished sensation in the distal phalanges and mild grip weakness, without lower limb involvement. Laboratory testing excluded common metabolic and nutritional causes. Electromyography and nerve conduction studies confirmed demyelinating polyneuropathy consistent with chronic inflammatory demyelinating polyneuropathy (CIDP). The patient was treated with intravenous immunoglobulin, which led to a marked improvement in symptoms, with sustained remission during follow-up. This case demonstrates an atypical sensory-predominant CIDP variant restricted to the upper extremities in the context of UC. It highlights the importance of considering autoimmune neuropathies in IBD patients presenting with unusual neuropathic symptoms and underscores the need for comprehensive neurologic evaluation to prevent diagnostic delays and optimize patient outcomes.