[Chronic Inflammatory Demyelinating Polyneuropathy]

Fortschr Neurol Psychiatr. 2016 Dec;84(12):756-769. doi: 10.1055/s-0042-120226. Epub 2016 Dec 12.
[Article in German]

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic progressive or relapsing autoimmune neuropathy with heterogeneous clinical presentation. Symptoms typically include symmetrical, proximal and/or distal paresis and sensory loss. Atypical CIDP variants are increasingly recognized, including subtypes with rapid onset as well as variants with pure sensory, focal or marked asymmetrical deficits. Diagnosis is established by compatible symptoms, characteristic electrophysiological features and cerebrospinal fluid analysis. In unequivocal cases, inflammatory infiltrates in sural nerve biopsy support the diagnosis. Recent studies suggest that diagnostic imaging techniques such as MRI and nerve ultrasound may become useful tools for establishing the diagnosis. First-line therapies include immunoglobulines, steroids, and plasmapheresis. Immunosuppressant agents and monoclonal antibodies are used in therapy-refractory cases or as cortison-saving agents.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Autoantibodies / blood
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / therapy
  • Biopsy
  • Diagnosis, Differential
  • Humans
  • Immunoglobulins / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Neurologic Examination
  • Peripheral Nerves / immunology
  • Peripheral Nerves / pathology
  • Plasma Exchange
  • Plasmapheresis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / immunology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy
  • T-Lymphocytes / immunology

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Autoantibodies
  • Immunoglobulins
  • Immunosuppressive Agents