Intractable chronic inflammatory demyelinating polyneuropathy treated successfully with ciclosporin.
BACKGROUND
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a heterogeneous disorder and both clinical course and response to treatment vary widely. Because of the propensity for relapse, CIDP requires maintenance therapy after the initial response to treatment. There is no consensus regarding this in the published literature.
A patient with CIDP was treated with oral prednisolone and cyclophosphamide pulse therapy but required repeated plasma exchange and intravenous immunoglobulin (IVIg). Treatment with ciclosporin freed the patient from repeated IVIg administration. Therapeutic responses in 14 subsequent cases including three patients who showed improvement with ciclosporin are also presented along with an algorithm of the authors' suggested protocol for treatment.


CONCLUSIONS
Ciclosporin should be considered for patients with intractable CIDP who require repeated IVIg.
Odaka
M
M
Department of Neurology, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, Japan. m-odaka@dokkyomed.ac.jp
Tatsumoto
M
M
Susuki
K
K
Hirata
K
K
Yuki
N
N
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000465:Algorithms; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002648:Child; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000503:physiopathology; D010951:Plasma Exchange / Q000379:methods; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000503:physiopathology*; D011239:Prednisolone / Q000627:therapeutic use; D020551:Pulse Therapy, Drug / Q000379:methods; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D002556:Cerebrospinal Fluid Proteins; D016756:Immunoglobulins, Intravenous; D016572:Cyclosporine; D003520:Cyclophosphamide; D011239:Prednisolone