Clinical Characteristics and Treatment Response of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

J Med Assoc Thai. 2017 Mar;100(3):262-9.

Abstract

Background: The incidence, prevalence, clinical phenotypes, and treatment response of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are varying in the world literature. There have been no epidemiologic studies of CIDP in Thai adult patients.

Objective: To determine clinical characteristics, phenotypes, electrophysiological tests, and treatment response of CIDP in Thai adult patients and to find factors associated with disease outcome after treatment.

Material and method: Retrospective chart review of Prasat Neurological Institute patients diagnosed of CIDP between January 1, 2008 and December 31, 2014.

Results: Sixty-three CIDP patients were identified. Patients were slightly male predominant (1.3:1), age at onset was 47.7 years, disease duration prior to first evaluation was 5.0 months, follow-up duration was 26.8 months, and 19% of patients had diabetes. Clinical phenotypes were classic CIDP (76.2%), 19% DADS, and 4.8% MADSAM. Fifteen point nine percent presented as AIDP and 12.7% as SIDP. Symmetrical, sensorimotor polyneuropathy with hyporeflexia were the common presentation. Autonomic symptoms, respiratory failure, bulbar involvement, ophthalmoparesis, ptosis, and muscle atrophy were rarely presented. The treatment response was generally favorable. Patients in disease relapsing group had shorter disease onset (2 vs. 6 months) and 40% had disease duration less than four weeks.

Conclusion: Clinical characteristics, phenotypes, electrophysiological findings, and treatment response of CIPD in Thai patients were not different from previously published studies in western and oriental populations. Mode of disease onset may predict a response to immunosuppressive treatment in CIDP patients.

MeSH terms

  • Adult
  • Aged
  • Azathioprine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunization, Passive
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Neurologic Examination
  • Plasmapheresis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy*
  • Prednisolone / therapeutic use
  • Retrospective Studies
  • Thailand

Substances

  • Immunosuppressive Agents
  • Prednisolone
  • Azathioprine