Acute motor response following a single IVIG treatment course in chronic inflammatory demyelinating polyneuropathy.
In chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the acute motor response following withdrawal and reestablishment of intravenous immunoglobulin (IVIG) therapy was studied. In a prospectively designed case series 11 CIDP patients in IVIG maintenance therapy were assessed with isokinetic dynamometry, nerve conduction studies, and functional tests. After short-term withdrawal of IVIG, eight treatment-responsive patients had a 14.2% (8.6-20.0) loss of isokinetic strength of 12 muscle groups. Three patients remained stable without treatment and were excluded from further study. On days 5 and 10 after reinitiation of IVIG therapy isokinetic muscle strength increased by 5.5% (1.6-9.6) and 11.9% (7.5-16.5), respectively, but there was no further increase at day 15. Improvement of walking velocity and hand function coincided. The minimal F-wave latency shortened, whereas other electrophysiological parameters remained unchanged. In conclusion, isokinetic dynamometry is a sensitive and clinically relevant method for monitoring the acute response to IVIG treatment in CIDP.
Harbo
Thomas
T
Department of Neurology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark. Thomas.harbo@ki.au.dk
Andersen
Henning
H
Jakobsen
Johannes
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D007551:Isotonic Contraction / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D053580:Muscle Strength / Q000187:drug effects* / Q000502:physiology; D053581:Muscle Strength Dynamometer; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D011788:Quality of Life; D011984:Sensory Receptor Cells / Q000502:physiology; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors