Plasma Exchange in Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Abstract

Plasma exchange has been reported to be efficacious in chronic inflammatory demyelinating polyradiculoneuropathy. We performed a prospective double-blind trial in which patients with static or worsening disease were randomly assigned to plasma exchange (n = 15) or to sham exchange (n = 14) for three weeks. After three weeks, we observed statistically significant differences in combined measurements of nerve conduction (total, motor, proximal, velocity, and amplitude) favoring patients who had received plasma exchange. Improvement to a greater degree than for any patient receiving sham exchange was detected in the neurologic-disability score in five patients (P = 0.025) and in subset scores for weakness and reflex in four patients (P less than 0.057). We conclude that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed. Because plasma was replaced with normal serum albumin, a humoral factor or factors may have a role in the neurologic deficit of this disorder.

"Chronic sensory demyelinating neuropathy": chronic inflammatory demyelinating polyneuropathy presenting as a pure sensory neuropathy.

“…Gradually, these sensory symptoms spread to the distal parts of the limbs, culminating in a symmetrical stocking-glove distribution in most cases. In one case (6), there were complaints of numbness in the left T8-10 dermatomes. In one case (10), unsteadiness was the chief complaint at the time of first evaluation because of sensory ataxia.…”

Cost–utility analysis of intravenous immunoglobulin and prednisolone for chronic inflammatory demyelinating polyradiculoneuropathy

“…It is characterised by slow onset of weakness and reduced sensation. It is a prolonged illness that has been shown to respond to a number of treatment regimes including intravenous immunoglobulin (IVIg), corticosteroids and plasma exchange [3][4][5][6][7][8]. Each of these interventions appears to be efficacious in the short term but little is known about the long-term effects.…”

Childhood Chronic Relapsing Inflammatorydemyelinating Polyradiculoneuropathy: Dramatic and Long-Lasting Response to Plasma Exchange

“…Finally, more than 20 months after treatment with plasma exchange, the patient has full muscle power. In the series of Dyck et al, 11 "improvement" began to disappear 10 to 14 days after treatment with plasma exchange. This may suggest that children have a better response to repeated plasma exchange than adults, probably due to disturbance in humoral more than cellular immunity.…”