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VOLUME 19 , ISSUE 2 ( 2015 ) > List of Articles


An unusual cause of type 2 respiratory failure

Balamurugan Nathan, Vivekanandan Pillai

Keywords : Chronic inflammatory demyelinating polyneuropathy, multiple myeloma, plasmapheresis, polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, type 2 respiratory failure

Citation Information : Nathan B, Pillai V. An unusual cause of type 2 respiratory failure. Indian J Crit Care Med 2015; 19 (2):122-125.

DOI: 10.4103/0972-5229.151023

License: CC BY-ND 3.0

Published Online: 01-01-2016

Copyright Statement:  Copyright © 2015; The Author(s).


We present a female patient who was referred for management of respiratory failure. She was being evaluated and managed as worsening chronic inflammatory demyelinating polyneuropathy with type 2 respiratory failure. Initial examination showed hypertrichosis, clubbing and papilledema along with severe distal and proximal motor-predominant weakness with impending respiratory failure. She was managed with noninvasive ventilation (NIV) and plasmapheresis awaiting diagnostic investigations. Immunofixation showed an "M band" and free lambda chain levels were elevated. Radiographs showed the classic osteosclerotic lesions of POEMS (polyradiculoneuropathy, organomegaly, endocrinopathy, M-protein and Skin abnormalities) syndrome. Six weeks after commencing radiotherapy to the osteosclerotic lesions, the patient responded favorably and remains off nocturnal NIV support.

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