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Volume 40, Number 4, August 2007

Chronic inflammatory demyelinating polyneuropathy associated with intestinal tuberculosis


Vui Heng Chong, Thykkoottathyl Pappy Joseph, Pemasiri Upali Telisinghe, Anand Jalihal
Gastroenterology Unit and Neurology Unit, Department of Medicine, and Department of Pathology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam

Received: August 15, 2006    Revised: February 27, 2007    Accepted: April 1, 2007   

 

Corresponding author:

Dr. Vui Heng Chong, Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam. E-mail: chongvuih@yahoo.co.uk This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Methods:

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an increasingly common but under-recognized neurological disorder. It is immune mediated, and usually has a relapsing and remitting course. However, the initial presentation may be rapid. It can be associated with significant morbidity and mortality, particularly if there is a delay in diagnosis and treatment. It has been associated with both infective and non-infective etiologies. We present a case of CIDP associated with ileocecal tuberculosis (TB), presenting with progressive motor weakness and significant weight loss. The patient’s symptoms improved to some extent with intravenous immunoglobulin and steroid, but improved significantly after being started on anti-TB therapy. However, his symptoms relapsed when he stopped his anti-TB treatment prematurely whilst continuing the immunosuppressive therapy. Upon resuming the anti-TB therapy, he made a good recovery. CIDP associated with TB has only been reported once. Our case highlights the need to consider TB in patients with neurological disorders.

 



 

Key words:

Immunosuppression; Polyradiculoneuropathy, chronic inflammatory demyelinating; Tuberculosis, gastrointestinal


 



 

J Microbiol Immunol Infect. 2007;40:377-380.