title: Diabetic demyelinating polyneuropathy responsive to intravenous immunoglobulin therapy.
abstract: BACKGROUND
  There is growing evidence that idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and polyneuropathy in patients with diabetes mellitus (DM) that meets the electrophysiological criteria for CIDP (DM-CIDP) have many similarities.
  
  
  OBJECTIVE
  To evaluate whether DM-CIDP responds to intravenous immunoglobulin (IVIG) therapy.
  
  
  METHODS
  Twenty-six patients (mean [SD] age, 64 [8.9] years; age range, 40-80 years) with type 2 DM (n = 25), who met the electrophysiological criteria for CIDP, were given IVIG therapy (400 mg/kg body weight per day for 5 days) in a prospective open-label pilot study. All patients had quantitative evaluation using the Neuropathy Impairment Score at baseline and at the end of 4 weeks from the initiation of IVIG therapy.
  
  
  RESULTS
  The mean Neuropathy Impairment Score improved significantly from baseline (mean [SD], 61.5 [26.0] points) to the end of the fourth week (33 [29.6] points; P<.00l). This clinically significant improvement occurred in 21 (80.8%) of the 26 patients. Conduction block occurred in 11 (42.3%) of the 26 patients; improvement in the Neuropathy Impairment Score was more frequent in patients who had a conduction block (11 of 11 patients) than in those who did not (10/15 [66.7%]; P =.03). Adverse reactions to IVIG included reversible renal dysfunction in 3 patients, flulike symptoms in 5, headache in 5, and chest pain and shortness of breath in 1.
  
  
  CONCLUSIONS
  Although IVIG therapy seemed to improve DM-CIDP in this uncontrolled trial, a controlled trial is required for confirmation of our findings.
authors.affiliation: Department of Neurology, University of Miami School of Medicine, 1150 NW 14th St, Room 603, Miami, FL 33136, USA. ksharma@med.miami.edu
authors.forename: Khema R
authors.initials: KR
authors.lastname: Sharma
authors.forename: John
authors.initials: J
authors.lastname: Cross
authors.forename: D Ram
authors.initials: DR
authors.lastname: Ayyar
authors.forename: Alberto
authors.initials: A
authors.lastname: Martinez-Arizala
authors.forename: Walter G
authors.initials: WG
authors.lastname: Bradley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003711:Demyelinating Diseases / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000628:therapy*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous