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Chronic inflammatory demyelinating polyneuropathy accompanied by carcinoma
  1. KAZUO ABE,
  2. FUMINOBU SUGAI
  1. Department of Neurology, Osaka University Medical School, 2–2 Yamadaoka, Suita, Osaka 565–0871, Japan
  1. Dr Kazuo Abe, Department of Neurology, Osaka University Medical School, 2–2 Yamadaoka, Suita, Osaka 565–0871, Japan. Telephone 0081 6 879 3579; fax 0081 6 879 3579; emailabe{at}neurol.med.osaka-u.ac.jp

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We read the article by Antonie et alwith interest.1 We have also reported on a patient with chronic inflammatory demyelinating polyneuropathy (CIDP) accompanied by hepatocellular carcinoma who showed improvement after intravenous methylpredonisolone injection.2 On the basis of this experience, we investigated 20 consecutive patients with pathologically established hepatocellular carcinoma in our hospital and found another patient having definite CIDP using the criteria of the Ad Hoc subcommittee of the American Academy of Neurology.3 This patient also had motorsensory neuropathy and showed improvement after intravenous methylpredonisolone injection. Our two patients showed a motorsensory neuropathy affecting the four limbs. Their CSF contained high concentrations of protein and the study of conduction velocities and biopsied nerves showed demyelination. We did not find anti-GM1 antibodies in either patient. As discussed in Antonieet al 1 the association of carcinoma and primary demyelinating neuropathy has seldom been reported. However, the cases reported by Antonie et al as well as us suggest the possibility that weakness or clumsiness, which is sometimes seen in patients with carcinoma may be caused by CIDP, and these symptoms should not be misinterpreted as representing general weakness caused by malignancies. Further investigation with large numbers of patients may be useful in determining the mechanism.

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