Diabetic demyelinating polyneuropathy responsive to intravenous immunoglobulin therapy

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Abstract

Background: There is growing evidence that idiopathic chronic inflammatory demyelinating polyneuropathy (CIDP) and polyneuropathy in patients with diabetes mellitus (DM) that meets the electrophysiological criteria for CIDP (DM-CIDP) have many similarities. Objective: To evaluate whether DM-CIDP responds to intravenous immunoglobulin (IVIG) therapy. Patients and Methods: Twenty-six patients (mean [SD] age, 64 [8.9] years; age range, 40-80 years) with type 2 DM (n = 25), who met the electrophysiological criteria for CIDP, were given IVIG therapy (400 mg/kg body weight per day for 5 days) in a prospective open-label pilot study. All patients had quantitative evaluation using the Neuropathy Impairment Score at baseline and at the end of 4 weeks from the initiation of IVIG therapy. Results: The mean Neuropathy Impairment Score improved significantly from baseline (mean [SD], 61.5 [26.0] points) to the end of the fourth week (33 [29.6] points; P<.001). This clinically significant improvement occurred in 21 (80.8%) of the 26 patients. Conduction block occurred in 11 (42.3%) of the 26 patients; improvement in the Neuropathy Impairment Score was more frequent in patients who had a conduction block (11 of 11 patients) than in those who did not (10/15 [66.7%]; P=.03). Adverse reactions to IVIG included reversible renal dysfunction in 3 patients, flulike symptoms in 5, headache in 5, and chest pain and shortness of breath in 1. Conclusion: Although IVIG therapy seemed to improve DM-CIDP in this uncontrolled trial, a controlled trial is required for confirmation of our findings.

Original languageEnglish
Pages (from-to)751-757
Number of pages7
JournalArchives of Neurology
Volume59
Issue number5
StatePublished - May 27 2002

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Passive Immunization
Diabetic Neuropathies
Intravenous Immunoglobulins
Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Diabetes Mellitus
Therapy
Polyneuropathies
Chest Pain
Dyspnea
Type 2 Diabetes Mellitus
Headache
Body Weight
Kidney

ASJC Scopus subject areas

  • Neuroscience(all)

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Diabetic demyelinating polyneuropathy responsive to intravenous immunoglobulin therapy. / Sharma, Khema R; Cross, John; Ayyar, D. Ram; Martinez-Arizala, Alberto; Bradley, Walter G.

In: Archives of Neurology, Vol. 59, No. 5, 27.05.2002, p. 751-757.

Research output: Contribution to journalArticle

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