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Subcutaneous Immunoglobulin in Infantile Chronic Inflammatory Demyelinating Polyneuropathy: A Case Report
Paola Cianci1, Silvia Salvatore1, Alex Moretti1
1Woman and Child Department, Ospedale "F. Del Ponte," University of Insubria, Varese, Italy.
Insights
Subcutaneous immunoglobulins (SCIgs) offer a promising alternative for pediatric Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) management. This approach improved a young patient
Area of Science:
- Neurology
- Immunology
Background:
- Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare, antibody-mediated sensorimotor disorder in children.
- Current pediatric CIDP treatments lack robust evidence-based efficacy and can be challenging to administer.
- Intravenous immunoglobulins (IVIgs) are common but often uncomfortable for pediatric patients.
Observation:
- A 7-year-old boy with CIDP showed clinical response to IVIg but required ongoing treatment.
- The patient's quality of life was impacted by the need for IVIg therapy.
Findings:
- Switching the pediatric CIDP patient from IVIg to subcutaneous immunoglobulins (SCIgs) resulted in an excellent clinical outcome.
- SCIgs demonstrated effectiveness in this case, mirroring findings in adults and other pediatric immune disorders.
Implications:
- Subcutaneous immunoglobulins (SCIgs) represent a viable and potentially more comfortable alternative for managing pediatric CIDP.
- This case highlights the potential of SCIgs to improve treatment adherence and quality of life in children with CIDP.
- Further research into SCIgs for pediatric CIDP is warranted to establish evidence-based guidelines.
Abstract:
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing sensorimotor disorder presumably due to antibody-mediated reactions. It is a rare condition in children, with estimated prevalence as 0.48 per 100,000 among patients younger than 20 years of age. Recommended treatments include immune modulators, intravenous immunoglobulins (IVIgs), steroids, and plasmapheresis. Management of pediatric CIDP is challenging because of the lack of evidence-based efficacy of the current therapies in children. Because of the rarity of this condition, there are no double-blind randomized studies to support the therapeutic choice as well as to identify the optimal first-line therapeutic regimen. IVIgs are widely used but the intravenous administration is usually uncomfortable, especially for children. Subcutaneous immunoglobulins (SCIgs) have proven to be effective in adults with CIDP and in children affected by antibody deficiencies and other different immune and inflammatory disorders. Herein, we described the case of a 7-year-old boy, affected by CIDP who clinically responded to IVIg but was dependent on this therapy. In order to improve his quality of life, we switched to SCIg with excellent result.
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