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Chronic inflammatory demyelinating polyneuropathy and pregnancy: systematic review
Felix Kohle1, Satoshi Kuwabara2, Helmar Christoph Lehmann3
1Neurology, Medical Faculty of the University of Cologne, Koln, Nordrhein-Westfalen, Germany.
Journal of Neurology, Neurosurgery, and Psychiatry
|February 10, 2021
Summary
Pregnancy can trigger the onset or relapse of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a rare immune-mediated neurological disorder. Treatments like corticosteroids are safe and effective for pregnant women with CIDP.
Area of Science:
- Neurology
- Immunology
- Obstetrics
Background:
- Immune-mediated neurological disorders are influenced by pregnancy.
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is the most common chronic immune-mediated neuropathy.
- Pregnancy's impact on CIDP has been minimally studied, primarily through case reports.
Purpose of the Study:
- To systematically review the literature on CIDP onset or relapse during pregnancy.
- To understand the characteristics and outcomes of pregnant women with CIDP.
- To evaluate the safety and efficacy of CIDP treatments during pregnancy.
Main Methods:
- Systematic literature review from January 1, 1969, to June 30, 2020.
- Inclusion of cases reporting CIDP onset or relapse during pregnancy.
- Analysis of patient demographics, CIDP subtypes, and treatment responses.
Main Results:
- Identified 24 women with CIDP onset or relapse during pregnancy.
- 71% developed CIDP during their first pregnancy; 47% experienced relapse in subsequent pregnancies.
- All identified CIDP cases were typical; first-line treatments (corticosteroids, IVIg, plasma exchange) were safe and effective.
Conclusions:
- Pregnancy may trigger typical CIDP in susceptible women.
- Women with pre-existing CIDP have an increased risk of relapse during pregnancy.
- CIDP onset or relapse in pregnancy presents a rare but significant clinical challenge.
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