Efficacy of Apheresis in Chronic Inflammatory Demyelinating Polyradiculoneuropathy(Special Issue in Hornor of the Retirement of Professor Toshiko Takemiya at the Department of Neurology, Tokyo Women's Medical University)

Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is chronic progressive or relapsing type of neuropathy. It's clinical features are variable and its etiology is still not completely known. Corticosteroids, immunosuppressants, apheresis and high-dose intra-venous immunoglobulin are used as treatment. In the present study, we compared the short- and long-term clinical efficacy of steroids and apheresis in 17 patients with CIDP. Five cases were treated with steroids alone and 12 cases were treated with apheresis with or without other treatment. Clinical symptoms were evaluated and peripheral nerve conduction studies conducted before treatment, and 1, 6 and 12 months after the treatment. Clinical symptoms and the functional stage were evaluated by the Neurological Disability Score (NDS) and the Rankin scale (RS), respectively. After 1 month, statistically significant improvement of NDS and RS was noted in the apheresis group. After 3 months, significant improvement was noted in the steroid group. There were no significant differences between two groups at 6 months and 1 year after the treatment. In both groups withdrawal of the steroids resulted in clinical relapse in patients who were followed up for more than 4 years, continued administration of small amount of steroids were needed to prevent relapses. Clinical worsening caused by steroid reduction rapidly and dramatically improved when combined with apheresis