G. Blume et al., ANTI-MAG ANTIBODY-ASSOCIATED POLYNEUROPATHIES - IMPROVEMENT FOLLOWINGIMMUNOTHERAPY WITH MONTHLY PLASMA-EXCHANGE AND IV-CYCLOPHOSPHAMIDE, Neurology, 45(8), 1995, pp. 1577-1580
Treatment outcomes of sensory-motor polyneuropathies associated with a
nti-myelin-associated glycoprotein (MAG) antibodies have varied even w
ith relatively intensive immunosuppression. We used plasma exchange an
d cyclophosphamide to treat four patients with anti-MAG antibody-assoc
iated polyneuropathies whose symptoms had progressed in the preceding
year. Treatment courses consisted of five to seven monthly regimens of
plasma exchange on 2 consecutive days followed by intravenous cycloph
osphamide (1 g/m(2)). Effects of treatment were quantitatively measure
d with hand-held dynamometry. All four patients showed improvement in
both strength and sensation in the 5 to 24 months after treatment. We
conclude that selected patients with sensory-motor polyneuropathies as
sociated with high-titer serum IgM autoantibodies against MAG may have
quantitative and useful functional improvement after immunotherapy, T
he improvement continues after completion of treatment and may persist
for 1 to 2 years or longer.