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Original Paper

Optimization of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy Evaluated by Grip Strength Measurement

Kokubun N.a · Sada T.a · Yuki N.b · Okabe M.a · Hirata K.a

Author affiliations

aDepartment of Neurology, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan; bDepartment of Medicine, Yong Loo Ling School of Medicine, National University of Singapore, Singapore

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Eur Neurol 2013;70:65-69

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 12, 2012
Accepted: February 24, 2013
Published online: June 19, 2013
Issue release date: August 2013

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE

Abstract

Background: Optimal dose and timing of repeated intravenous immunoglobulin therapy (IVIg) for intractable chronic inflammatory demyelinating polyneuropathy (CIDP) patients have not been determined. The aim of this study was to optimize dose and timing of IVIg for CIDP patients who need frequent IVIg using daily grip strength measurement. Methods: Repeated IVIg were administered for two intractable CIDP patients. Grip strength was recorded at home every day to access the clinical change in symptoms, and dose and timing of IVIg were optimized based on the results. Results: The decrement on grip strength was a sensitive indicator of symptom exacerbation. 100 g of IVIg had a limited effect for each patient. In one patient, symptoms maintained after monthly 60 g of IVIg. In another, 100 g of IVIg every 7 weeks resulted in a marked improvement. After receiving 20 g of IVIg weekly, each patient showed further improvement. Conclusion: Optimal dose and timing possibly vary in each individual patient. Dose titration of IVIg is necessary to avoid over- and undertreatment. The daily self-monitoring of grip strength is a helpful tool for clinical assessment in CIDP.

© 2013 S. Karger AG, Basel


References

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 12, 2012
Accepted: February 24, 2013
Published online: June 19, 2013
Issue release date: August 2013

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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