Chronic inflammatory demyelinating polyradiculoneuropathy

Bergh, Peter Van den; Rajabally, Yusuf A.

doi:10.1016/j.lpm.2013.01.056

Cited by 33 publications

(18 citation statements)

References 156 publications

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“…The guideline also has advised the addition of corticosteroids or an immunosuppressive agent when frequent IVIg is required [1]. However, many CIDP patients might be overtreated [2,3,4,5]. Recent investigations demonstrated that grip strength is a sensitive tool for assessing clinically relevant changes during repeated IVIg in patients with CIDP [6,7].…”

Section: Introductionmentioning

confidence: 99%

Optimization of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy Evaluated by Grip Strength Measurement

et al. 2013

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Background: Optimal dose and timing of repeated intravenous immunoglobulin therapy (IVIg) for intractable chronic inflammatory demyelinating polyneuropathy (CIDP) patients have not been determined. The aim of this study was to optimize dose and timing of IVIg for CIDP patients who need frequent IVIg using daily grip strength measurement. Methods: Repeated IVIg were administered for two intractable CIDP patients. Grip strength was recorded at home every day to access the clinical change in symptoms, and dose and timing of IVIg were optimized based on the results. Results: The decrement on grip strength was a sensitive indicator of symptom exacerbation. 100 g of IVIg had a limited effect for each patient. In one patient, symptoms maintained after monthly 60 g of IVIg. In another, 100 g of IVIg every 7 weeks resulted in a marked improvement. After receiving 20 g of IVIg weekly, each patient showed further improvement. Conclusion: Optimal dose and timing possibly vary in each individual patient. Dose titration of IVIg is necessary to avoid over- and undertreatment. The daily self-monitoring of grip strength is a helpful tool for clinical assessment in CIDP.

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Section: Introductionmentioning

confidence: 99%

Optimization of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy Evaluated by Grip Strength Measurement

et al. 2013

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“…There have been reports of delayed diagnosis of MGUS in CIDP patients [3]. This patient’s pattern of sensory losses greater than motor losses and bilateral INO are patterns of neuropathy that have been described in multiple myeloma-associated CIDP [9]. Further, his initial poor response to IVIG is a pattern described in other monoclonal gammopathy-associated neuropathies [1].…”

Section: Discussionmentioning

confidence: 87%

“…Protein electrophoresis and immunofixation of the serum and the urine are routinely used [7]. Some have suggested that nerve biopsy may elucidate the neuropathy’s etiology, but the result is not consistent [9]. Ultrasound has been proposed as a less invasive way to diagnose paraproteinemic neuropathies.…”

Section: Discussionmentioning

confidence: 99%

Multiple Myeloma Associated Chronic Inflammatory Demyelinating Polyradiculoneuropathy: The Importance of Continued Surveillance

Fasanya

Loncharich

Gandhi

et al. 2016

Cureus

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune disease presenting with weakness and numbness in a remitting or chronic progressive course. It is known to have several clinical presentations and several associated diseases. CIDP has been associated with multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS), and other paraproteinemias. We present a case of refractory CIDP in which the initial workup for multiple myeloma was negative, and multiple myeloma was then diagnosed two and half years later. Treatment of the multiple myeloma led to clinical improvement. This case is instructive in that perhaps more frequent surveillance for paraproteinemia in patients with CIPD, even after a negative initial workup, could lead to a better clinical outcome.

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“…The demyelination and nerve conduction block seen in inflammatory PN suggests that circulating humoral factors, along with antibodies and activated B cells or plasma cells play a key part in immune neuropathies associated with IBD. Finally, T-cells are implicated in IBD pathogenesis but they are also involved in the pathogenesis of demyelinating neuropathies: dysfunction of immunoregulatory T-cells and increased levels of interleukin-17 have been reported [41,42].…”

Section: Pathogenesis Of Ibd-associated Peripheral Neuropathiesmentioning

confidence: 99%

Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease

García-Cabo

Morís

2015

European Journal of Internal Medicine

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Chronic inflammatory demyelinating polyradiculoneuropathy

Cited by 33 publications

References 156 publications

Optimization of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy Evaluated by Grip Strength Measurement

Optimization of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy Evaluated by Grip Strength Measurement

Multiple Myeloma Associated Chronic Inflammatory Demyelinating Polyradiculoneuropathy: The Importance of Continued Surveillance

Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease

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