Disclosures: Naveen S. Khokhar, DO: No financial relationships or conflicts of interest

Case Description: A 22 year old female presented with progressive sensory changes and extremity weakness over five days. Patient endorsed nonspecific symptoms of illness prior to the development of weakness. The physical exam was significant for absent distal reflexes.

Setting: Tertiary Academic Medical Center

Patient: A 22 year old female with no significant past medical history Assessment/

Results: development of weakness. The physical exam was significant for absent distal reflexes. Electrodiagnostic (EDx) findings were consistent with an early proximal demyelinating polyneuropathy consistent with acute inflammatory demyelinating polyneuropathy (AIDP) due to prolonged F-wave latencies. Albuiminocytodissociation was noted on lumbar puncture. Serologic studies were negative for HIV and positive for syphilis. Of note, the patient had negative syphilis testing two months prior to this admission. The patient was treated with plasmapheresis and a 10 day course of penicillin and showed gradual improvement in strength.

Discussion: AIDP is an immune-mediated polyneuropathy that leads to injury to the myelin or axon of the peripheral nerves resulting in progressive weakness and paresthesias. While AIDP is well associated with HIV and campylobacter infections, it has not been correlated with syphilis infections. In this case, patient had nonspecific constitutional symptoms prior to developing weakness and paresthesias with an acutely positive syphilis test consistent with a syphilis induced AIDP.

Conclusion: This is the first case to our knowledge of AIDP occurring in a patient following an acute syphilis infection. More research is needed to explore if syphilis can trigger AIDP especially in the context of an increasing incidence of syphilis in the population. Syphilis testing could be considered in select patients with new onset AIDP

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/can-acute-inflammatory-demyelinating-polyneuropathy-be-triggered-by-an-acute-syphilis-infection-a-case-report/