Unmasking the mimic: Leprosy neuropathy misdiagnosed as chronic inflammatory demyelinating polyneuropathy: A case report from Saudi Arabia

Abstract

Leprosy neuropathy can mimic chronic inflammatory demyelinating polyneuropathy (CIDP), especially in non-endemic areas. We report a 72-year-old Saudi woman initially misdiagnosed with CIDP based on nerve conduction studies. The patient presented with widespread pruritus, erythematous cutaneous lesions, and progressive sensorimotor symptoms. Despite treatment with intravenous immunoglobulin, her condition worsened. Subsequent sural nerve and skin biopsies revealed acid-fast bacilli, confirming leprosy. This case highlights the importance of considering leprosy in the differential diagnosis of neuropathies, even in regions where it is rare. Nerve ultrasound, a valuable diagnostic tool in differentiating leprosy from CIDP, should be incorporated into the diagnostic workup of atypical neuropathies.