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Plasma exchange in chronic inflammatory polyneuropathy: Evidence suggestive of a pathogenic humoral factor
Author(s) -
Toyka Klaus V.,
Augspach Regine,
Wiethölter Horst,
Besinger Uwe A.,
Haneveld F.,
Liebert Uwe G.,
Heininger Kurt,
Schwendemann G.,
Reiners Karlheinz,
Grabensee Bernd
Publication year - 1982
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880050610
Subject(s) - azathioprine , immunosuppression , chronic inflammatory demyelinating polyneuropathy , medicine , antibody , immunohistochemistry , immunology , polyneuropathy , peripheral neuropathy , sciatic nerve , prednisolone , pathology , endocrinology , disease , diabetes mellitus
Abstract Chronic progressive or relapsing inflammatory polyneuropathy (CRIP) can be treated effectively with immunosuppressive drugs and/or plasma exchange (PE). This report describes a patient who responded dramatically and reproducibly to PE during four successive relapses and remained in remission while on medical immunosuppression with azathioprine and corticosteroids. The clinical course was closely correlated with electrophysiologic parameters such as compound muscle action potential amplitudes and distal latencies. The purified lgG fraction of PE filtrate bound to rat and human sciatic nerve on immunohistochemistry. Furthermore, a similar staining pattern was achieved by purified Fab fragments, which was absent in all control preparations. These findings support the hypothesis that circulating plasma factors may play a role in CRIP and that one of these factors may be an IgG antibody to peripheral nerve components.