慢性炎症性脱髄性多発根ニューロパチー，多巣性運動ニューロパチーの治療

DOI
  • 神田 隆
    山口大学大学院医学系研究科神経内科学

書誌事項

タイトル別名
  • Treatment of chronic inflammatory demyelinating polyradiculoneuropathy and multifocal motor neuropathy

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説明

<p>Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) are representative autoimmune peripheral neuropathy which can be adequately treated by immunotherapy. The first line treatment regimen in CIDP include oral corticosteroids, plasma exchange (PE), and intravenous immunoglobulin (IVIg). These three are equally effective in CIDP, and the second line or adjunctive therapies such as oral immunosuppressants are far much less effective. In MMN, only IVIg is designated as first line treatment and corticosteroids may worsen the limb weakness of patients. Therapeutic approaches against CIDP and MMN must be based on the accurate diagnosis, because several conditions such as sarcoidosis, Lyme disease, malignant lymphoma. HIV neuropathy may mimic CIDP and fulfil the diagnostic criteria for CIDP. Because the currently used diagnostic criteria for CIDP are intended to pick up patients as many as possible, we should be careful not to overdiagnose CIDP. However, at the same time, a lot of CIDP/MMN patients remain undiagnosed in Japan ; we should avoid underdiagnosis of these treatable neuropathies.</p>

収録刊行物

  • 神経治療学

    神経治療学 34 (3), 178-181, 2017

    日本神経治療学会

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