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Office immunotherapy in chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy.

Abstract
Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-based immunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons).
AuthorsPeter J Dyck, Bruce V Taylor, Jenny L Davies, Michelle L Mauermann, William J Litchy, Christopher J Klein, P James B Dyck
JournalMuscle & nerve (Muscle Nerve) Vol. 52 Issue 4 Pg. 488-97 (Oct 2015) ISSN: 1097-4598 [Electronic] United States
PMID25976871 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
Copyright© 2015 Wiley Periodicals, Inc.
Chemical References
  • Adrenal Cortex Hormones
  • Immunoglobulins, Intravenous
Topics
  • Action Potentials
  • Adrenal Cortex Hormones (therapeutic use)
  • Electromyography
  • Female
  • Humans
  • Immunoglobulins, Intravenous
  • Immunotherapy (methods)
  • Male
  • Neural Conduction (physiology)
  • Neuromuscular Diseases (immunology, physiopathology, therapy)
  • Plasma Exchange (methods)
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating (immunology, physiopathology, therapy)
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome

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