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ABSTRACT: We report an adult patient with refractory chronic inflammatory demyelinating polyneuropathy (CIDP) who resisted conventional immunological therapies but could be successfully treated with interferon (IFN)-alpha 2a. A 56-year-old man was admitted to our hospital with progressive distal dominant muscle weakness and sensory disturbance of all extremities. He was diagnosed as CIDP based on laboratory examinations which revealed conduction block on peripheral nerve conduction studies and demyelinating findings on sural nerve biopsy. He was given several immunological treatments, including immunoadsorption therapy (IAT), oral corticosteroid, immunosuppressive agents such as cyclophosphamide and mizoribine, but without satisfactory efficacy although transient improvement of muscle weakness was observed for two weeks after IAT. A session of IAT every four weeks was therefore continued to maintain his symptoms for nine months. He was then treated with IFN-alpha 2a intramuscular injections every other day. Four weeks after starting of IFN-alpha 2a therapy, the worsening of his symptoms stopped and his muscle strength improved gradually to normal level without IAT, suggesting that IFN-alpha 2a may be effective in some patients with refractory CIDP. Further studies are needed to confirm the efficacy of IFN-alpha 2a for CIDP.
Rinsho shinkeigaku = Clinical neurology 03/2000; 40(2):155-9.