A 37-year-old HIV-positive man has had a relapsing and remitting course of motor and sensory problems for the past year, including difficulty with ambulation as well as symmetric numbness and tingling in all extremities. Nerve conduction studies show findings consistent with demyelination and remyelination. He is treated with plasmapheresis. Which of the following disorders is most likely to cause this man's neurologic disease?
Chronic inflammatory demyelinating polyneuropathy (CIDP) can be seen in patients with immunologic diseases. Treatment may aid recovery, but a chronic course may ensue. Bacterial infections produce signs of acute inflammation with redness and swelling and tend not to involve nerves specifically. Some paraneoplastic syndromes may occur with carcinomas, such as Lambert-Eaton myasthenic syndrome, with weakness. Carcinomas are less likely at this age and are not frequent complications of HIV infection. Hyperglycemia is characteristic of diabetes mellitus, and diabetic neuropathy is likely to be progressive and unremitting. Traumatic injury is unlikely to produce such widespread findings and unlikely to be followed by a variable course.
Bacterial infection
Carcinoma
Hyperglycemia
Immune dysregulation
Peripheral Nerve & Skeletal Muscles