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Pulse steroid inflammatory polyneuropathy

Yusuke Seino, Takumi Nakamura, Mie Hirohata, Takeshi Kawarabayashi, Toshimi Okushima, Mikio Shoji
We report the case of a 53-year-old woman with severe chronic inflammatory demyelinating polyneuropathy (CIDP) who developed progressive tetraplegia with respiratory failure despite receiving a standard dose of intravenous immunoglobulin therapy (IVIg), steroid pulse therapy, plasma exchange, and cyclosporine. We administered high-dose IVIg (3 g/kg; 0.6 g/kg/day for 5 consecutive days at monthly intervals). The patient's muscle weakness gradually improved after IVIg. She recovered completely 2 years after the onset of symptoms...
November 19, 2018: Internal Medicine
Jong Youb Lim, Young-Ho Lim, Eun-Hi Choi
INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune disorder with progressive weakness. Acute-onset CIDP resembles Guillain-Barre syndrome (GBS), a rapidly progressive disorder, and follows a chronic course. To our knowledge, no case of acute-onset CIDP in hantavirus and hepatitis B virus (HBV) coinfection has been reported previously. CLINICAL FINDINGS: We report a case of acute-onset CIDP that was initially diagnosed as GBS...
December 2016: Medicine (Baltimore)
H Chatani, M Tanaka, T Nagata, T Araki, S Kusunoki
Anti-ganglioside antibodies have been reported in various peripheral neuropathies, including Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, Fisher syndrome, monoclonal gammopathy-associated neuropathy, and other idiopathic neuropathies. To our knowledge, there has been no report of anti-ganglioside-positive sarcoidosis. We report a 62-year-old man with acute weakness of the limbs and sensory disturbance of the right arm and trunk resembling GBS...
January 2014: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Rie Motoyama, Kentaro Yamakawa, Seiko Suzuki, Susumu Kusunoki, Masami Tanaka
Polyneuropathy associated with antibodies directed against myelin-associated glycoprotein (MAG) is a chronic symmetric sensorimotor demyelinating neuropathy caused by monoclonal IgM against MAG (anti-MAG neuropathy). Intravenous immunoglobulin therapy (IVIg) has been partially successful in patients with anti-MAG neuropathy. A placebo-controlled trial of rituximab in patients with anti-MAG neuropathy has been reported. We report rapid improvement in a patient with anti-MAG neuropathy using rituximab. A 58-year-old man presented with abnormal sensation, weakness of the limbs, and unsteadiness...
October 2011: Rinshō Shinkeigaku, Clinical Neurology
Philippe Hantson, Luc Kevers, Nicole Fabien, Peter Van Den Bergh
We examined a 27-year-old woman who developed rapidly progressive quadriplegia and acute respiratory failure that required mechanical ventilation in the intensive care unit. It was unclear whether this was a presentation of Guillain-Barré syndrome (GBS) or acute-onset chronic inflammatory demyelinating polyradiculoneuropathy (A-CIDP). Remarkable features included multiple cranial nerve involvement, respiratory failure, dysautonomia, and skin manifestations. Several autoantibodies were elevated, including antinuclear (ANA), anticardiolipin (aCL), thyroid, and calcium-sensing receptor (CaSR) autoantibodies...
March 2010: Muscle & Nerve
Suraj Ashok Muley, Gareth J Parry
Early and effective treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) is important to minimize axonal degeneration that occurs secondary to demyelination. The disease course is invariably chronic, so long-term treatment is often required, and adverse effects and costs are important considerations in devising a treatment plan. CIDP responds to prednisone, but long-term treatment can result in significant adverse effects. Azathioprine, mycophenolate mofetil, and cyclosporine can be used as steroid-sparing agents and may facilitate more rapid and successful tapering of prednisone...
May 2009: Current Treatment Options in Neurology
Suraj Ashok Muley, Praful Kelkar, Gareth J Parry
BACKGROUND: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy that responds to various immunosuppressive treatments. Oral daily prednisone therapy is effective and inexpensive, but the long-term treatment that is usually necessary leads to serious adverse effects. Consequently, intravenous immunoglobulin and plasma exchange have been widely used to treat CIDP, making treatment expensive and inconvenient. A steroid regimen that reduces adverse effects but preserves efficacy would simplify treatment...
November 2008: Archives of Neurology
Somporn Wongraoprasert, Patinut Buranasupkajorn, Vitaya Sridama, Thiti Snabboon
We present a young Thai man who developed acute flaccid paralysis after receiving pulse methylprednisolone for chronic inflammatory demyelinating polyneuropathy. Hypokalemia from intracellular shift was confirmed by calculation of transtubular potassium gradient (TTKG). His muscle strength and serum potassium fully recovered with a small amount of potassium replacement. Graves' disease was subsequently diagnosed and treated with radioactive iodine. We suggest that acute paralysis after the use of steroids should raise a suspicion of thyrotoxic periodic paralysis (TPP)...
2007: Internal Medicine
H Nakajima, K Shinoda, Y Doi, M Tagami, D Furutama, M Sugino, F Kimura, T Hanafusa
OBJECTIVE: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune syndrome where certain autoantibodies define clinicopathologic subgroups. In the present study, serum anti-cardiolipin antibodies (aCL) were evaluated. MATERIALS AND METHODS: We investigated aCL in sera from 21 patients diagnosed with CIDP in our hospital between 1991 and 2001. The four CIDP patients with aCL (aCL+) were compared with 17 patients without aCL (aCL-). RESULTS: All aCL+ patients displayed sensory-motor polyneuropathy, with severity and distribution of weakness resembling those in aCL- patients...
April 2005: Acta Neurologica Scandinavica
T Watanabe, S Shimoji, Y Sugiyama, T Tsukamoto, T Yamamoto
Eight patients with neuroimmunological disorders refractory to conventional immunotherapies were given totally 17 courses of pulse-dose cyclophosphamide. The regimen consisted of 600 mg/m2 of intravenous cyclophosphamide at days 1,2,4,6 and 8 and infusion of 2,500-3,000 ml of fluids in order to avoid hemorrhagic cystitis. Some cases were followed by a monthly intravenous dose of cyclophosphamide as a booster treatment. As a result, all but one case of neuro-Behçet disease have shown neurological improvements...
June 1995: Rinshō Shinkeigaku, Clinical Neurology
R Hishida, M Baba, H Shimamura, M Matsunaga, K Takebe
A 47-year-old female patient with chronic inflammatory demyelinating polyneuropathy started to recover from her numbness and weakness within a few hours following the commencement of intravenous methylprednisolone 1,000 mg. In parallel with the recovery of muscle strength, a prolonged latency time of the M-wave was normalized within a day by a revival of the new motor units with a normal latency. In many cases with CIDP, it has been recognized that the gradual decrease in latency time over weeks is a later phenomenon following early increase in amplitude of the M-wave during recovery of weakness, which is explained by remyelinating process...
February 1993: Rinshō Shinkeigaku, Clinical Neurology
K Saida
Immunosuppressive treatments of neuro-immunologic diseases: myasthenia gravis, polymyositis, chronic inflammatory demyelinating polyneuropathy and multiple sclerosis were reviewed. The treatments need to be planned in terms of 2-5 years. Cautions must be taken for adverse effects of short and long terms. Corticosteroids were the most well used and were studied medication of the first choice among immunosuppressants in these diseases except for CIDP in which large amounts of IV-Ig or plasmapheresis are the first choice...
November 1994: Nihon Rinsho. Japanese Journal of Clinical Medicine
Y Maegaki, J Tohyama, K Takeshita
A case of early-onset and slowly progressive chronic inflammatory demyelinating polyneuropathy (CIDP) was reported. Her progressive gait disturbance began at six years of age and she developed pes cavus. At the age of 13 years, a diagnosis of CIDP was made, and oral corticosteroid therapy was started. This therapy was effective, but the disease relapsed soon. Muscular strength improved after supplementation of an immunosuppressant with oral corticosteroid, following steroid pulse therapy. On peripheral motor conduction study, M waves showed very low amplitudes and remarkably delayed onset-latencies...
November 1994: No to Hattatsu. Brain and Development
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