[Steroid therapy and plasmapheresis in chronic inflammatory demyelinating polyradiculoneuropathy: a long-term...

We report eight patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), paying special attention to the therapeutic effects of steroid and plasmapheresis. Each patient underwent 4 to 51 plasmapheresis sessions in addition to prednisolone therapy. Plasmapheresis was more effective in patients with motor neuropathy (6 patients) than in those with sensory neuropathy (2 patients). Concomitant steroid therapy enhanced the short-term efficacy of plasmapheresis. During a long-term follow-up, the patients who showed deteriorating clinical symptoms such as limb weakness, sensory disorder, decreased deep tendon reflexes and increased CSF proteins underwent plasmapheresis once or twice a month. This intermittent plasmapheresis could reduce the use of prednisolone or eventually discontinue the drug completely. We were not able to determine whether immunoadsorption plasmapheresis or double-filtration plasmapheresis was more effective for the patients with CIDP. CIDP is characterized by frequent recurrences of a chronic progressive course, and peripheral neuropathy and some patients with this disease are resistant to many therapeutic approaches. The present study strongly suggests that plasmapheresis with concomitant steroid therapy is very useful for both short- and long-term treatment of CIDP patients.