Interferon beta-1a in chronic inflammatory demyelinating polyneuropathy: case report

Abstract

-Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated neuropathy. It presents with a course of progression which may be slow and steady or step-wise or relapsing. Sensory ataxic polyneuropathy may be the only clinical manifestation of this disease. Treatment with interferon β1a (INF β1a) has been tried with different results in patients who were refractory to other, more conventional, immunomodulatory therapies. Here we report on a patient who had a relapsing form of pure sensory ataxic CIDP and who failed to respond to intravenous human immunoglobulin. He was put on INF β1a for 3 years. During this period he suffered no relapses while his condition stabilized.KEY WORDS: CIDP, peripheral neuropathy, interferon β (IFN β).Interferon beta en polineuropatía crónica inflamatoria desmienlinizante: caso clínico RESUMEN -La polineuropatía crónica inflamatoria desmielinizante (PCID) es una neuropatía inmuno-mediada, que presenta un curso clínico primariamente progresivo o en forma de recaídas. Las manifestaciones sensoriales pueden ser su unica forma de expresión clínica. El tratamiento con interferon beta 1a (IFN β1a) ha sido ensayado en varias oportunidades, con diferentes respuestas terapéuticas, en pacientes refractarios a las terapias inmunomoduladoras convencionales. Nosotros comunicamos un paciente con una forma ataxica recurrente de PCID, que no respondió al tratamiento con inmunoglobulina endovenosa. Posteriormente fue tratado con IFN β 1 a por tres años. Durante el período de seguimiento no mostró nuevas recaídas y su cuadro neurológico se estabilizó. PALABRAS-CLAVES: neuropatia periferica, interferon beta.In a recent publication, JM Vallat, et al 1 described the results of using intramuscular (IM) Interferon (IFN) β1a to treat patients with chronic inflammatory demyelinating polyneuropathy (CIDP). The investigators found that this medication had an excellent safety and tolerability profile, and that it lead to a statistically significant improvement in the symptoms of neurological disability in some of their patients, those with pure sensory neuropathy were excluded. CIDP is an acquired immune-mediated neuropathy which presents with a course of progression that may be slow and steady or step-wise or relapsing. Sensory ataxic polyneuropathy may be the only clinical manifestation of the disease 2 . Treatments are designed to modulate the abnormal immune response and to suppress ongoing disease activity. Here we report on a patient who had a relapsing form of pure clinical sensory ataxic CIDP and failed to respond to intravenous human immunoglobulin (IVIg) treatment. He was then put on IFN β1a for a period of three years. CASEA 39-year old man presented with a 9-year history of pain, imbalance, and numbness and paresthesias in both feet and hands. The disease presented a relapsing course from the beginning; periods in which the patient´s condition suddenly worsened were followed by others when it stabilized. The patient was suffering one of his relapses when he was firs...