Treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulin

Authors
Citation
Af. Hahn, Treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulin, NEUROLOGY, 51(6), 1998, pp. S16-S21
Citations number
74
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurology,"Neurosciences & Behavoir
Journal title
NEUROLOGY
ISSN journal
0028-3878 → ACNP
Volume
51
Issue
6
Year of publication
1998
Supplement
5
Pages
S16 - S21
Database
ISI
SICI code
0028-3878(199812)51:6<S16:TOCIDP>2.0.ZU;2-I
Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a defined clini cal entity with a chronic progressive or chronic relapsing course, lasting months to years. It causes variable but often severe chronic disability. CI DP is considered an autoimmune disorder caused by both cellular and humoral immune processes. Various immunomodulatory therapies, i.e., Mg, therapeuti c plasma exchange (PE), and prednisone, are of proven benefit. Comparative studies indicate that Mg and PE confer equal short-term benefit. Efficacy o f Mg is maintained; regularly timed pulse treatments may stabilize relapsin g CIDP. The combination of Mg and prednisone may be advantageous in long-te rm management. Despite the high cost, Mg is considered the preferred first treatment. The safety profile is similar to that reported far other conditi ons; close monitoring during the infusion is recommended. The precise mecha nisms of Mg action in CIDP are not known. Anti-idiotypic neutralization of autoantibodies, binding of complement, and blockade of macrophages may prev ent the ongoing inflammatory demyelination.