BACKGROUND: The prevalence and outcome of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients with solid organ transplantation is unknown, and there are no guidelines for the evaluation and treatment of such patients. METHODS: An 8 year long monocentric prospective study was conducted in which, in a population of 1557 solid organ transplant recipients, the characteristics of 10 consecutive patients (0.6%) who developed a syndrome that fulfilled the clinical, biological and electrophysiological criteria for definite CIDP were investigated. RESULTS: Five patients had liver transplantation, three had kidney transplantation, one had heart transplantation and one had lung transplantation. The mean interval between transplantation and CIDP was 10 months. Six patients developed CIDP after immunosuppressive therapy dosage was decreased and were treated with intravenous immunoglobulin (IVIG) and increased dosage of immunosuppressive therapy. Four patients were treated with IVIG only. Neuropathy improved in all cases, and CIDP had a monophasic course in all patients, with no relapse observed over a mean follow-up of 5 years. CONCLUSION: CIDP in solid organ transplant recipients is rare, appears in the first year after transplantation, has a monophasic course and is responsive to IVIG treatment. CIDP being treatable, it should be systematically considered in solid organ transplant recipients who develop a rapidly disabling sensorimotor polyneuropathy.
BACKGROUND: The prevalence and outcome of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients with solid organ transplantation is unknown, and there are no guidelines for the evaluation and treatment of such patients. METHODS: An 8 year long monocentric prospective study was conducted in which, in a population of 1557 solid organ transplant recipients, the characteristics of 10 consecutive patients (0.6%) who developed a syndrome that fulfilled the clinical, biological and electrophysiological criteria for definite CIDP were investigated. RESULTS: Five patients had liver transplantation, three had kidney transplantation, one had heart transplantation and one had lung transplantation. The mean interval between transplantation and CIDP was 10 months. Six patients developed CIDP after immunosuppressive therapy dosage was decreased and were treated with intravenous immunoglobulin (IVIG) and increased dosage of immunosuppressive therapy. Four patients were treated with IVIG only. Neuropathy improved in all cases, and CIDP had a monophasic course in all patients, with no relapse observed over a mean follow-up of 5 years. CONCLUSION:CIDP in solid organ transplant recipients is rare, appears in the first year after transplantation, has a monophasic course and is responsive to IVIG treatment. CIDP being treatable, it should be systematically considered in solid organ transplant recipients who develop a rapidly disabling sensorimotor polyneuropathy.
Authors: Mohamed Mahdi-Rogers; Ruth Brassington; Angela A Gunn; Pieter A van Doorn; Richard Ac Hughes Journal: Cochrane Database Syst Rev Date: 2017-05-08
Authors: Marieke van der Zwan; Dennis A Hesselink; Esther Brusse; Pieter A van Doorn; Martijn W F van den Hoogen; Annelies E de Weerd; Bart C Jacobs Journal: Neurol Neuroimmunol Neuroinflamm Date: 2020-04-16