• Simona Portaro, Fiammetta Biasini, Placido Bramanti, Antonino Naro, and Rocco Salvatore Calabrò.
• IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy.
• Medicine (Baltimore). 2020 Jul 10; 99 (28): e21117.

Introductionwe report on the first case of a woman affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and recessive myotonia congenita (MC), treated with mexiletine. We aimed at describing the possible role of mexiletine in CIDP management.Patient ConcernsA 44-year-old female affected by CIDP and MC, gained beneficial effects for CIDP symptoms (muscle weakness, cramps, and fatigue) and relapses, after mexiletine intake (200 mg twice a day). The patient presented with detrimental effects after mexiletine drop out, with a worsening of CIDP symptoms.InterventionsThe patient reported a nearly complete remission of muscle stiffness and weakness up to 3 years since mexiletine intake. Then, she developed an allergic reaction with glottis edema, maybe related to mexiletine intake, as per emergency room doctors' evaluation, who suggested withdrawing the drug.OutcomesThe patient significantly worsened after the medication drop out concerning both CIDP and MC symptoms.ConclusionThis is the first report on the association of CIDP and MC in the same patient. Such diseases may share some clinical symptoms related to a persistent sodium currents increase, which maybe due either to the over-expression of sodium channels following axonal damage due to demyelination or to the chloride channel genes mutations. This is the possible reason why mexiletine maybe promising to treat CIDP symptoms.

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