[Clinical judgment and decision making in medical practice. A retiree with fatigue and foot drop]

Ned Tijdschr Geneeskd. 1998 Jan 24;142(4):174-9.
[Article in Dutch]

Abstract

A 64-year-old former civil servant consulted his general practitioner because of severe fatigue. Later he began to lose weight and gradually developed chronic sensorimotor polyneuropathy characterized by sensory nerve loss which started in his legs. After a year he needed a wheel chair and developed cachexia. IgG paraprotein was detected. Morbid-anatomical examination of enlarged supraclavicular lymph nodes revealed plasma cell angiofollicular hyperplasia, characteristic of Castleman's disease. Treatment with corticosteroids led to marked improvement of the patient's condition. He was able to walk again, using an ankle orthosis on both legs.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Castleman Disease / complications*
  • Castleman Disease / diagnosis
  • Castleman Disease / drug therapy
  • Diagnosis, Differential
  • Fatigue / etiology*
  • Foot / innervation
  • Humans
  • Male
  • Middle Aged
  • Movement Disorders / etiology*
  • Paraneoplastic Syndromes / diagnosis
  • Paraproteinemias / diagnosis
  • Peripheral Nervous System Diseases / diagnosis
  • Prednisone / therapeutic use
  • Vitamin B 12 Deficiency / diagnosis

Substances

  • Anti-Inflammatory Agents
  • Prednisone