Chronic Immune Dysschwannian/Dysneuronal
Polyneuropathy is an autoimmune peripheral-nerve and/or
nerve-root disorder known to usually respond to
intravenous immunoglobulin-G treatment. Benefit can involve any combination of motor-nerve fibers and large and small sensory-nerve fibers responsible for a progressively crippling, unbalancing, discomforting or painful disorder. "
Diabetic neuropathy" is commonly considered untreatable. However, 81% of my 48 recently-summarized type-2 diabetes patients with
polyneuropathy, adequately-treated with
intravenous immunoglobulin-G, off-label, were relieved, sometimes completely, of various motor and sensory symptoms, including
pain, thereby resembling Chronic Immune Dysschwannian/Dysneuronal
Polyneuropathy. Spinal fluid
protein in them is often elevated, higher values seeming to auger a better
intravenous immunoglobulin-G response. Continuing the improvement requires continuing the
intravenous immunoglobulin-G treatment, indicating both
intravenous immunoglobulin-G responsiveness and dependency. The
intravenous immunoglobulin-G responsive type-2 diabetes
polyneuropathy usually is dysschwannian, sometimes mainly dysneuronal
intravenous immunoglobulin-G, the most beneficial and safest treatment, is costly, but if
intravenous immunoglobulin-G-treatability of a dysimmune component of type-2 diabetes neuropathy is overlooked, dismissed or rejected, as commonly happens, other costs are high regarding the patient's worsening morbidity and disability, and resultant need for increased medical care. A novel
intravenous immunoglobulin-G regimen effective for fragile patients is Two Non-Consecutive-Days Every Week, using 0.4 gm/kg body wt/day. Possible molecular mechanisms of
intravenous immunoglobulin-G benefit are discussed. I propose that a) there is a higher incidence of Chronic Immune Dysschwannian/Dysneuronal
Polyneuropathy-like neuropathy in
type-2 diabetes patients and in patients with a strong family history of
type-2 diabetes, and b) the
intravenous immunoglobulin-G-treatable neuropathy in
type-2 diabetes can be brought on by the genetico-diabetoid-2 state. The genetic-metabolic milieu (but not necessarily
glucose dysmetabolism per se.) of
type-2 diabetes putatively predisposes to the presumably-dysimmune
intravenous immunoglobulin-G-responsive
polyneuropathy. In some of our patients, especially ones having a strong
type-2 diabetes genetic background, the
intravenous immunoglobulin-G-responsive neuropathy preceded the diagnosis of
type-2 diabetes by 5-10 years. Accordingly, Chronic Immune Dysschwannian/Dysneuronal
Polyneuropathy patients having a strong
type-2 diabetes genetic background are designated "genetico-diabetoid-2 neuropathy" prior to their manifesting
type-2 diabetes.
Intravenous immunoglobulin-G is herein suggested as a treatment for
Severe Acute Respiratory Syndrome, a recent, and feared-repetitive, pandemic with many fatalities caused by a highly-contagious mutant coronavirus, for which there is no definitive treatment.
Intravenous immunoglobulin-G might: a) combat a dysimmune component of
Severe Acute Respiratory Syndrome, including the reactive
cytokine-
chemokine storm against respiratory tissues; b) contain some
antibodies effective against the coronavirus non-specific components of
Severe Acute Respiratory Syndrome; c) block host-cell receptors for the virus; and d) counteract
secondary infections.