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We report a case of chronic acquired neuropathy predominantly affecting sensory and autonomic nerves. Investigations showed a demyelinating polyradiculoneuropathy with axonal degeneration and depletion of postganglionic noradrenergic fibers in the rectal mucosa. Intravenous immunoglobulin and corticosteroid administration were effective in alleviating symptoms and improving electrophysiological abnormalities. This neuropathy may be a novel variant of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), in which autoimmunoreactivity is directed not only against myelin but also against axon- or ganglion-composing protein. Autonomic nerve involvement does not exclude a diagnosis of CIDP.

A 64-year-old man was admitted to our hospital complaining of non-productive cough and right chest pain. Chest radiographs showed bilateral hilar lymphadenopathy, diffuse granular nodules and right pleural effusion. Serumangiotensin-II-converting enzymeand lysozyme levels were elevated. Since thoracentesis indicated bloody pleurisy, video-assisted thoracoscopy was performed and revealed multiple white nodules on both the visceral and parietal pleura. Resected pleural biopsy specimens showed non-caseous granulomas. Furthermore, somenodules were observed to compress and involve small vessels and capillaries. The bloody pleurisy was assumed to have been derived from the rupture of small vessels that had been compressed and affected by the granuloma with sarcoidosis.

A 29-year-old womanwith no medical history had been conservatively treated at another hospital the 24th week of her gestation. The treatment consisted of restricted sodium intake for hypertension and proteinuria ascribable to preeclampsia. In the 29th week of her pregnancy she was admitted to the hospital because of sudden-onset nausea and abdominal pain. Laboratory data demonstrated elevated levels of aspartate aminotransferase (56 U//, normal 12-37 U//) and lactate dehydrogenase (690 U/Z, normal 1 14-220 U/Z) as well as anemia (hemoglobin 9.6 g/dl, normal 1 1.1-15.1 g/dl) and severe thrombocytopenia (3.0xl07mm3, normal 13.2-British Columbia's Women's Hospital & Health Centre, Vancouver, for providing us with clinical information regarding this patient.

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