Article Figures & Data
Figures
- Figure 1
- Multiple erythematous cutaneous lesions and joint swelling in her limbs.
- Figure 2
- Histopathologic findings of nerve biopsy.
Tables
Nerve conduction studies Prior treatment history Histopathology Endoneurial fibrosis Acid-fast bacilli Treatment/follow-up Initial NCS findings indicate the presence of a combination of demyelinating and axonal sensory-motor polyneuropathy. Developed symptoms of neuropathy before and during the treatment Lepromatous leprosy Not present Positive Treatment still on-going Follow up NCS Showing signs of a mixed sensorimotor with secondary axonal loss polyneuropathy, compared to her last study there is no substantial change, and the picture is within expected time frame. Dates Relevant past medical history and interventions 2 years prior to presentation Onset of widespread pruritus and erythematous cutaneous lesions, primarily affecting lower extremities Dates Summaries from initial and follow-up visits Diagnostic testing Interventions Month 0 Initial presentation with widespread pruritus, erythematous cutaneous lesions, and articulatory inflammation - Rheumatology, metabolism, and infection tests: No notable abnormalities
- Immunoglobulin G levels: 49.2 g/L (elevated)
- CSF analysis: No notable abnormalities
Month 6 Development of paresthesia, tingling, and numbness Month 8 Initial medical evaluation: - Reduced sensory reactions in L3, L4, L5 dermatomes
- Lack of vibration and proprioception in lower limbs
- Absent reflexes
- Bilateral strength rating: -4/5 in lower limbs, 4/5 in upper limbs
Nerve conduction studies: Suggestive of combined demyelinating and axonal sensory-motor polyneuropathy Month 9 Diagnosis of CIDP based on nerve conduction studies Month 10-11 Five consecutive IVIG treatments Month 12 Significant decline in condition Sixth IVIG treatment Month 14 Sural nerve biopsy: Revealed lymph histiocytic infiltration and acid-fast bacilli
Skin biopsy: Showed mixed dermal inflammation with non-necrotizing granuloma and acid-fast bacilliMonth 15 Diagnosis of leprosy confirmed Current Signs of improvement Ongoing antibiotic treatment
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