Clinical reasoning: a 40-year-old man with CIDP-like illness resistant to treatment.

Lahoria, Rajat; Karam, Chafic; Dispenzieri, Angela; Dyck, P James B · Neurology · 2013

case_report · Level V

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Abstract

A 40-year-old man developed tingling and numbness in the feet 2 years ago. Three months later, he noticed difficulty standing on his toes. Outside evaluation showed a small immunoglobulin G (IgG) lambda paraprotein, elevated CSF protein of 335 mg/dL (<40 mg/dL), and nerve root thickening with mild gadolinium enhancement in the cauda equina region on lumbar spine MRI. He was presumed to have Guillain-Barré syndrome (GBS) and was treated with IV immunoglobulin (IVIg).

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