Download PDF
Fortschr Neurol Psychiatr 2024; 92(06): 247-258
DOI: 10.1055/a-2238-8294
Fort- und Weiterbildung

Chronische inflammatorische demyelinisierende Polyradikuloneuropathie (CIDP)

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)
Barbara Kaulen
,
Laura Hagemann
,
Helmar C. Lehmann
› Further Information
Also available at
    Permissions and Reprints

Corrected by:

Erratum: Chronische inflammatorische demyelinisierende Polyradikuloneuropathie (CIDP)Fortschr Neurol Psychiatr 2024; 92(06): e1-e1
DOI: 10.1055/a-2356-6913

Die chronische inflammatorische demyelinisierende Polyradikuloneuropathie (CIDP) ist die häufigste chronische Autoimmunerkrankung des peripheren Nervensystems. Sie ist häufig schwierig zu diagnostizieren. Die CIDP ist mittlerweile mittels verschiedener Immuntherapeutika gut behandelbar. In diesem Beitrag wird die Diagnose und Therapie der CIDP anhand eines typischen Fallbeispiels erläutert.

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic autoimmune disease of the peripheral nervous system. It is often difficult to diagnose, but severaly therapeutic options are nowadays available to reduce neurological deficits and to improve the disease course. This article exemplifies the management of CIDP by a typical case study.

Schlüsselwörter

Neuropathie - Immunoglobulin - Autoimmunerkrankung - Demyelinisierung

Keywords

Neuropathy - Immunoglobulin - Autoimmune disease - demyelination


Publication History

Article published online:
14 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Lehmann HC, Burke D, Kuwabara S. Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment. J Neurol Neurosurg Psychiatry 2019; 90: 981-987
    CrossrefPubMedSearch in Google Scholar
  • 2 Sommer C, Koch S, Lammens M. et al. Macrophage clustering as a diagnostic marker in sural nerve biopsies of patients with CIDP. Neurology 2005; 65: 1924-1929
    CrossrefPubMedSearch in Google Scholar
  • 3 Vural A, Doppler K, Meinl E. Autoantibodies against the node of ranvier in seropositive chronic inflammatory demyelinating polyneuropathy: diagnostic, pathogenic, and therapeutic relevance. Front Immunol 2018; 9: 1029
    CrossrefPubMedSearch in Google Scholar
  • 4 Bäumer D, Grant DJ, Knight R. et al. CIDP presenting as recurrent severe back pain without weakness or sensory loss. Pract Neurol 2016; 16: 488-492
    CrossrefPubMedSearch in Google Scholar
  • 5 Di Guglielmo G, Di Muzio A, Torrieri F. et al. Low back pain due to hypertrophic roots as presenting symptom of CIDP. Ital J Neurol Sci 1997; 18: 297-299
    CrossrefPubMedSearch in Google Scholar
  • 6 Mahdi-Rogers M, Hughes RC. Epidemiology of chronic inflammatory neuropathies in southeast England. Eur J Neurol 2014; 21: 28-33
    CrossrefPubMedSearch in Google Scholar
  • 7 Lefter S, Hardiman O, Ryan AM. A population-based epidemiologic study of adult neuromuscular disease in the Republic of Ireland. Neurology 2017; 88: 304-313
    CrossrefPubMedSearch in Google Scholar
  • 8 Mengel D, Fraune L, Sommer N. et al. Costs of illness in chronic inflammatory demyelinating polyneuropathy in Germany. Muscle Nerve 2018; 58: 681-687
    CrossrefPubMedSearch in Google Scholar
  • 9 Guptill JT, Bromberg MB, Zhu L. et al. Patient demographics and health plan paid costs in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2014; 50: 47-51
    CrossrefPubMedSearch in Google Scholar
  • 10 Kaplan A, Brannagan TH. Evaluation of patients with refractory chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2017; 55: 476-482
    CrossrefPubMedSearch in Google Scholar
  • 11 Allen JA, Lewis RA. CIDP diagnostic pitfalls and perception of treatment benefit. Neurology 2015; 85: 498-504
    CrossrefPubMedSearch in Google Scholar
  • 12 Allen JA, Ney J, Lewis RA. Electrodiagnostic errors contribute to chronic inflammatory demyelinating polyneuropathy misdiagnosis. Muscle Nerve 2018; 57: 542-549
    CrossrefPubMedSearch in Google Scholar
  • 13 Van den Bergh PYK, van Doorn PA, Hadden RDM. et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint Task Force-Second revision. J Peripher Nerv Syst 2021; 26: 242-268
    CrossrefPubMedSearch in Google Scholar
  • 14 Üçeyler N, Necula G, Wagemann E. et al. Endoneurial edema in sural nerve may indicate recent onset inflammatory neuropathy. Muscle Nerve 2016; 53: 705-710
    CrossrefPubMedSearch in Google Scholar
  • 15 Grimm A, Axer H, Heiling B. et al. Nerve ultrasound normal values – Readjustment of the ultrasound pattern sum score UPSS. Clin Neurophysiol 2018; 129: 1403-1409
    CrossrefPubMedSearch in Google Scholar
  • 16 Querol L, Nogales-Gadea G, Rojas-Garcia R. et al. Neurofascin IgG4 antibodies in CIDP associate with disabling tremor and poor response to IVIg. Neurology 2014; 82: 879-886
    CrossrefPubMedSearch in Google Scholar
  • 17 Doppler K, Appeltshauser L, Wilhelmi K. et al. Destruction of paranodal architecture in inflammatory neuropathy with anti-contactin-1 autoantibodies. J Neurol Neurosurg Psychiatry 2015; 86: 720-728
    CrossrefPubMedSearch in Google Scholar
  • 18 van Schaik IN, Eftimov F, van Doorn PA. et al. Pulsed highdose dexamethasone versus standard prednisolone treatment for chronic inflammatory demyelinating polyradiculoneuropathy (PREDICT study): a double-blind, randomised, controlled trial. Lancet Neurol 2010; 9: 245-253
    CrossrefPubMedSearch in Google Scholar
  • 19 Lehmann HC, Hartung H-P. Plasma exchange and intravenous immunoglobulins: mechanism of action in immunemediated neuropathies. J Neuroimmunol 2011; 231: 61-69
    CrossrefPubMedSearch in Google Scholar
  • 20 Cornblath DR, van Doorn PA, Hartung H-P. et al. Randomized trial of three IVIg doses for treating chronic inflammatory demyelinating polyneuropathy. Brain 2022; 145: 887-896
    CrossrefPubMedSearch in Google Scholar
  • 21 Adrichem ME, Lucke IM, Vrancken AFJE. et al. Withdrawal of intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy. Brain 2022; 145: 1641-1652
    CrossrefPubMedSearch in Google Scholar
  • 22 Yoon MS, Chan A, Gold R. et al. Standard and escalating treatment of chronic inflammatory demyelinating polyradiculoneuropathy. Ther Adv Neurol Disord 2011; 4: 193-200
    CrossrefPubMedSearch in Google Scholar
  • 23 Isose S, Mori M, Misawa S. et al. Long-term regular plasmapheresis as a maintenance treatment for chronic inflammatory demyelinating polyneuropathy. J Peripher Nerv Syst 2010; 15: 147-149
    CrossrefPubMedSearch in Google Scholar
  • 24 Lehmann HC, Hartung H-P, Hetzel GR. et al. Plasma exchange in neuroimmunological disorders: part 2. Treatment of neuromuscular disorders. Arch Neurol 2006; 63: 1066-1071
    CrossrefPubMedSearch in Google Scholar
  • 25 Lieker I, Slowinski T, Harms L. et al. A prospective study comparing tryptophan immunoadsorption with therapeutic plasma exchange for the treatment of chronic inflammatory demyelinating polyneuropathy. J Clin Apheresis 2017; 32: 486-493
    CrossrefPubMedSearch in Google Scholar
  • 26 Davies AJ, Fehmi J, Senel M. et al. Immunoadsorption and plasma exchange in seropositive and seronegative immunemediated neuropathies. J Clin Med 2020; 9: 2025
    CrossrefPubMedSearch in Google Scholar
  • 27 Liu L, Chen J, Zhang Y. et al. Case report: Immunoadsorption therapy for anti-caspr1 antibody-associated nodopathy. Front Immunol 2022; 13: 986018
    CrossrefPubMedSearch in Google Scholar
  • 28 Good JL, Chehrenama M, Mayer RF. et al. Pulse cyclophosphamide therapy in chronic inflammatory demyelinating polyneuropathy. Neurology 1998; 51: 1735-1738
    CrossrefPubMedSearch in Google Scholar
  • 29 Querol L, Rojas-García R, Diaz-Manera J. et al. Rituximab in treatment-resistant CIDP with antibodies against paranodal proteins. Neurol Neuroimmunol Neuroinflammation 2015; 2: e149
    CrossrefPubMedSearch in Google Scholar
  • 30 Härtig F, Ross M, Dammeier NM. et al. Nerve ultrasound predicts treatment response in chronic inflammatory demyelinating polyradiculoneuropathy – a prospective followup. Neurotherapeutics 2018; 15: 439-451
    CrossrefPubMedSearch in Google Scholar
  • 31 Balke M, Wunderlich G, Brunn A. et al. Chronische inflammatorische demyelinisierende Polyneuropathie. Fortschr Neurol Psychiatr 2016; 84: 756-769
    Thieme ConnectPubMedSearch in Google Scholar