CIDP‐like neuropathies in graft versus host disease

Abstract

Cases of chronic inflammatory demyelinating poliradiculoneuropathy (CIDP) have been reported in hematopoietic stem cells transplantation complicated by graft versus host disease (GVHD). A systematic review of the CIDP-like neuropathies associated with GVHD was conducted until January 2015, analyzing the clinical presentation and the response to different therapeutic regimens. Nineteen patients have been reported in literature including the present one. Fourteen subjects fulfilled the criteria for CIDP, whereas two cases presented with an asymmetric motor onset and one showed motor involvement only associated with anti-ganglioside antibodies. In addition, two subjects already affected by CIDP developed a significant relapse after GVHD. This study reviews the literature data and reports one additional case of CIDP and GVHD, suggesting that the two clinical entities might share a similar immunological background.

Delayed‐onset inflammatory polyneuropathy without graft versus host disease after bone marrow transplantation

“…Among 19 patients reviewed, 17 had de novo CIDP after BMT. The average time of onset in these cases was approximately 15 months, ranging from 2 weeks to 5 years . Post‐BMT CIDP without GVHD has been reported in a single case of juvenile‐onset α‐mannosidosis 19 months after BMT .…”

“…In previously reported cases (accompanied by GVHD), about 80% of patients had complete recovery after immunomodulatory treatments . However, the course and response to treatment in isolated post‐BMT CIDP have not been established.…”

“…Immune‐mediated peripheral nervous system complications after bone marrow transplantation (BMT) are uncommon . Demyelinating polyneuropathies constitute a small proportion of these events . Currently, most cases of patients with post‐BMT chronic inflammatory demyelinating polyneuropathy (CIDP) that have been reported have been associated with graft versus host disease (GVHD) .…”

“…1,2 Demyelinating polyneuropathies constitute a small proportion of these events. 2,3 Currently, most cases of patients with post-BMT chronic inflammatory demyelinating polyneuropathy (CIDP) that have been reported have been associated with graft versus host disease (GVHD). 3 Here we report 2 cases of CIDP without GVHD, developing 4 years after BMT.…”

“…2,3 Currently, most cases of patients with post-BMT chronic inflammatory demyelinating polyneuropathy (CIDP) that have been reported have been associated with graft versus host disease (GVHD). 3 Here we report 2 cases of CIDP without GVHD, developing 4 years after BMT. Four years after BMT, he began developing slowly progressive weakness and paresthesia of the limbs and no craniobulbar or sphincter symptoms.…”