Chronic Inflammatory Demyelinating Polyradiculoneuropathy,in an 8-Year-Old Girl,Complicated by Deafness and Kidney Fibrosis

Abstract

Based on case history and clinical and electrophysiological examinations, the authors report on a case of an 8-year-old girl who was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy. The disease was complicated by deafness and kidney fibrosis. During treatment with methylprednisolone and intravenous immunoglobulin, followed by mycophenolate mofetil, prompt improvement of neurological findings occurred. The improvement of hearing was poor. Because the pathogenesis of chronic inflammatory demyelinating polyradiculoneuropathy has still not been clear, and on the grounds of several cases of chronic inflammatory demyelinating polyradiculoneuropathy conjoined with the kidney disease described in literature (glomerulopathy, interstitial nephritis), every patient with chronic inflammatory demyelinating polyradiculoneuropathy needs to undergo the urinalyses.

Keywords

chronic inflammatory demyelinating polyradiculoneuropathy deafness kidney fibrosis

Get full access to this article

View all access options for this article.

References

Koller H. , Kieseier BC , Jander S. Chronic inflammatory demyelinating polyneuropathy. N Engl J Med. 2005;352:1343-1356.

Chio A. , Cocito D. , Battacchi E. , et al. Idiopathic chronic inflammatory demyelinating polyneuropathy: an epidemiological study in Italy. J Neurol Neurosurg Psychiatry . 2007;78: 1349-1353.

Brown WF , Snow R. Patterns and severity of conduction abnormalities in Guillain-Barré syndrome . J Neurol Neurosurg Psychiatry. 1994;54:768-774.

Kuwabara S. , Misawa S. , Mori M. , Tamura N. , Kubota M. , Hattori T. Long term prognosis of chronic inflammatory demyelinating polyneuropathy: a five year follow up of 38 cases. J Neurol Neurosurg Psychiatry . 2006;77:66-70.

Hartung HP , Stoll G. , Toyka KV Immune reactions in the peripheral nervous system. In: Dyck PJ , Thomas PK , Griffin JW , eds. Peripheral Neuropathy. 3rd ed. Philadelphia, PA: Sanders; 1995:418-444.

Misawa S. , Kuwabata S. , Mori M. Serum levels of tumor necrosis factor-alpha in chronic inflammatory demyelinating polyneuropathy. Neurology. 2001;55:666-669.

Kieseir K. Immune mechanism in chronic inflammatory demyelinating neuropathy . Neurology. 2002;59:7-12.

Hughes ACR , Allen D. , Makowska A. , Gregson NA Pathogenesis of chronic inflammatory demyelinating polyradiculoneuropathy . J Peripher Nerv Syst. 2006;11:30-46.

Simmons Z. , Wald J. , Albers J. Chronic inflammatory demyelinating polyradiculoneuropathy in children: I. Presentation, electro-diagnostic studies, and initial clinical course, with comparison to adults. Muscle Nerve. 1997 ;20:1008-1015.

10.

Simmons Z. , Wald J. , Albers J. Chronic inflammatory demyelinating polyradiculoneuropathy in children: II. Long-term follow-up, with comparison to adults. Muscle Nerve . 1997;20: 1569-1575.

11.

Yamamoto T. , Ohnishi A. , Miyoshi T. , Hashimoto T. , Murai Y. A case of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with bilateral recurrent nerve palsy and primary alveolar hypoventilation-comparative studies of the histological findings of the two sural nerve biopsies with 9 years interval . Clini Neurol. 1994;34:712-716.

12.

Sasaki M. , Ohara S. , Oide T. , et al. An autopsy case of chronic inflammatory demyelinating polyradiculoneuropathy with respiratory failure. Muscle Nerve. 2004 ;30:382-387.

13.

Kimber TE , Orrell RW , King RH , Ginsberg L. Pathological findings in a patient with ventilatory failure and chronic inflammatory demyelinating polyneuropathy. J Peripher Nerv Syst. 2003;8:13-16.

14.

Hengsman GJD , Schelhaas HJ , Zwarts MJ Auditory dysfunction in chronic inflammatory demyelinating polyradiculoneuropathy. Neurology. 2004;2:1446-1448.

15.

Sivakumar K. , Fife TD Autoimmune hearing loss in chronic inflammatory demyelinating polyneuropathy. Neurology. 2005 ; 65:1673-1674.

16.

Mahmood P. , Truongl LD , Eknoyan G. Membranous glomerulonephritis associated with inflammatory demyelinating peripheral neuropathies. Am J Kidney Dis. 1996;27:279-283.

17.

Chen KH , Chang CT , Hung CC Glomerulonephritis associated with chronic inflammatory demyelinating polyneuropathy . Ren Fail. 2006;28:255-259.

18.

Henderson RD , Healy HG , MaCombe PA , Lander CM Chronic inflammatory demyelinating polyradiculoneuropathy and severe peripheral oedema: a renal explanation. J Clin Neurosci. 2000;7: 148-149.

19.

Katsuyoshi K. , Chieko N. , Hisato S. , et al. Renal glucosuria and membranous glomerulonephritis in chronic inflammatory demyelinating polyradiculoneuropathy: CIDP. Japanese J Nephrol. 1999;41:511-516.