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Introduction: CIDP is characterized by symmetrical weakness in both proximal and distal muscles that progressively increases for more than two months. It may be associated to auto-immune and infectious conditions. We report a case in which the diagnosis of CIDP has led to a diagnosis of IBD, although the first hypothesis was Vitamin B12 deficiency.

Methods: Case report and literature review on the themes.

Case Description: Twelve-year-old boy was admitted with four-week weakness in the lower limbs without any sensitive alteration or pain. He had a history of chronic diarrhea since age 4, associated with malnutrition and recurrent bronchospasm. His exam showed gait instability, lower limbs weakness and absence of deep tendon reflexes of both legs. After four weeks hospitalized, evolved with loss of gait and tactile sensitive alteration, worsening bronchospasm and pneumonia. He had Vitamin B12 deficiency, macrocytic anemia, elevated muscle enzymes, normal CSF and hyperintense signal of the conus medullaris on the MRI. The electroneuromyography showed motor-sensitive chronic demyelinating polyrradiculoneurophaty with axonal predominance. After hidroxycobalamin reposition, he had a slight improvement, but only got better after corticosteroid pulse therapy. On corticosteroid suspension, at the follow up, his diarrhea returned and colonoscopy demonstrated colon stenosis suggesting IBD.

Conclusion/Discussion: CIDP is an underdiagnosed and potentially treatable disease. In our case, although we do not have a nerve biopsy, the clinical pattern and findings on electroneuromyography, besides the response to corticosteroid, can assure the diagnosis of CIDP, especially considering the association with IBD.

Chronic Inflammatory Demyelinating Polyneuropathy; Inflammatory Bowel Disease; Vitamin B12 Deficiency