Chonnam Med J.  2002 Dec;38(4):421-425.

Cirrhotic Change after Corticosteroid Therapy in a Patient with Chronic Inflammatory Demyelinating Polyneuropathy

• Jhu IK
• Yang SH
• Tae CK
• Hwang YS
• Ji Y
• Hwang IY
• Shin GC

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a symmetrical motor and sensory polyneuropathy with a relapsing or progressive course. It has typical features of elevated CSF protein levels and the electrodiagnostic findings of acquired demyelination. The response to therapy suggests that CIDP is immune-mediated; CIDP responds to glucocorticoids. But long-term adverse effects of steroids including bone demineralization, gastrointestinal bleeding, and cushingoid changes are problematic. A 24 year-old male patient visited our hospital complaining of progressive tingling sensations in his arms and legs. Neurological examination revealed sensory and motor disturbance of the glove-and-stocking type in his all extremities. Cerebrospinal fluid studies showed albumino-cytologic dissociation. Motor nerve conduction studies revealed prolongation of terminal latencies, reduction of conduction velocities, and abnormal temporal dispersion of the motor potentials. No sensory potentials could be evoked at any of the sites stimulated. A diagnosis of CIDP was made, and we started to treat with corticosteroids. His biochemical and radiologic studies at first visit were compatible with chronic active hepatitis due to hepatitis B viral infection. He showed two neurological relapses for nine months. His hepatic dysfunction progressed, and abdominal CT scans showed liver cirrhosis and splenomegaly. Liver biopsy at referred hospital demonstrated liver cirrhosis and regenerating nodules.

Keyword

Polyneuropathy; Hepatitis B; Steroids

MeSH Terms

Adrenal Cortex Hormones
Arm
Biopsy
Cerebrospinal Fluid
Demyelinating Diseases
Diagnosis
Extremities
Glucocorticoids
Hemorrhage
Hepatitis B
Hepatitis, Chronic
Humans
Leg
Liver
Liver Cirrhosis
Male
Neural Conduction
Neurologic Examination
Polyneuropathies*
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating
Recurrence
Sensation
Splenomegaly
Steroids
Tomography, X-Ray Computed
Young Adult
Adrenal Cortex Hormones
Glucocorticoids
Steroids