Chronic inflammatory demyelinating polyneuropathy: A case report

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a treatable autoimmune neuropathic condition, which characterize progressive and relapsing stages. Major clinical presentations are gradatory increasing sensory loss and weakness interrelated with loss of reflexes. Relapse can occur at any time for CIDP patients. Diagnosis is based on cerebrospinal fluid protein, electromyography, nerve conduction velocity (NCV) test, peripheral nerve biopsy and electron micrograph of peripheral nerve. Standard treatments for CIDP are corticosteroids, Intravenous Immune Globulin (IVIG), plasma exchange or plasmapheresis. Second line drugs commonly used are immunosuppressant and immune modulatory agents, there are usually chemotherapy drugs which should be only given in special circumstances by specialist in their use. A 55 year old female encountered in the department of neurology, old case of Guillain-Barre Syndrome (GBS) was treated with steroids, later developed CIDP and was on reduced dose of prednisolone. Now presented with complaints of numbness and difficulty in walking, diagnosed to have CIDP relapse. Started treatment with corticosteroid [Tab. Wysolone (prednisolone) 50mg 1-0-0] and immunosuppressant [Tab. Cellcept (mycophenolate mofetil) 500mg 1-0-1]. Patient had significant improvement in symptoms. This case of CIDP relapse is effectively treated with corticosteroid and immunosuppressant with tapering of steroid dose.