Treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulin.
Chronic inflammatory demyelinating polyneuropathy is an immune-mediated demyelinating peripheral neuropathy usually treated with immunosuppressants. We reviewed our experience treating 15 patients (9 men, 6 women) with intravenous immunoglobulin. Six patients were on other therapies at the time of intravenous immunoglobulin infusions (4, prednisone; 2, prednisone and azathioprine). The dose of intravenous immunoglobulin was either 0.3 or 0.4 gm/kg/day for 4 to 5 days. Transient fever occurred in 1 patient. Subjective improvement in sensory symptoms was reported by almost all patients. Objective improvements in strength or functional tasks occurred in only 3 patients, a man with human immunodeficiency virus infection, a 14-year-old girl, and a woman with an immunoglobulin G kappa paraprotein. Our results suggest that individual patients may respond to intravenous immunoglobulin therapy. A multicenter controlled trial is needed to assess properly the role of intravenous immunoglobulin therapy in patients with chronic inflammatory demyelinating polyneuropathy.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
D R
DR
Cornblath
V
V
Chaudhry
J W
JW
Griffin
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications; D003131:Combined Modality Therapy; D003711:Demyelinating Diseases / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007116:Immunization, Passive; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000628:therapy; D010265:Paraproteinemias / Q000150:complications; D011115:Polyneuropathies / Q000150:complications / Q000188:drug therapy / Q000628:therapy*
D007166:Immunosuppressive Agents