Chronic inflammatory demyelinating polyradiculopathy as a paraneoplastic manifestation of metastatic melanoma

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease that leads to proximal greater than distal weakness. It follows a relapsing course and requires treatment with chronic immune suppressing therapy such as steroids or intravenous immunoglobulin infusions. The vast majority of cases are idiopathic. However, there has been an established association with malignancy. Hematologic malignancies are the most commonly associated, but solid tumors are implicated as well. CIDP associated with melanoma has been reported in several previous case reports. Despite these reports, this association is not widely known. We report a case of a patient with a remote history of resected melanoma who developed severe refractory CIDP. He was found to have a recurrent metastatic melanoma. He experienced sustained clinical improvement with treatment of both the CIDP and malignancy. We then compare the characteristics of this case with others reported in the literature. This case along with other reports highlights the importance of being aware of this association and emphasizes that treatment of both the neuropathy and malignancy leads to maximal clinical effect.