Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) Developing During Tacrolimus Treatment: A Case...

Area of Science:

• Neurology
• Immunology
• Transplantation Medicine

Background:

• Tacrolimus is a vital immunosuppressant post-solid organ transplantation.
• Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) is a rare but serious neurological complication.
• The association between tacrolimus and CIDP is not widely recognized.

Purpose of the Study:

• To describe the clinical characteristics of CIDP in patients treated with tacrolimus.
• To investigate the diagnostic features and disease course of tacrolimus-induced CIDP.
• To evaluate treatment responses and outcomes in this patient cohort.

Main Methods:

• Retrospective case series of six patients diagnosed with CIDP.
• Patients received tacrolimus for solid organ transplantation.
• Diagnostic criteria (2021 EFNS/PNS) and treatment responses were analyzed.

Main Results:

• CIDP developed between 5 months and 13 years after tacrolimus initiation across various transplant types.
• Five out of six patients showed clinical improvement with intravenous immunoglobulin (IVIg).
• Switching immunosuppression to sirolimus or azathioprine led to disease remission in four patients.

Conclusions:

• Tacrolimus therapy may be associated with the development of CIDP, even after prolonged use.
• IVIg is an effective treatment for tacrolimus-associated CIDP.
• Alternative immunosuppressive agents can manage the condition, allowing for tacrolimus cessation.