IMPROVEMENT FOLLOWING INTERFERON-ALPHA 2A IN CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a progress ive or relapsing immune-mediated neuropathy usually responsive to plas ma exchange, intravenous gammaglobulin or steroids, with some patients being refractory to these conventional therapies. We report a patient with CIDP who had spontaneous improvement after an episode of sepsis, but subsequently relapsed with severe generalized weakness; he was un responsive to the conventional treatments for CIDP but had dramatic im provement following treatment with interferon-alpha 2A. Nerve conducti on studies following treatment showed improved distal compound muscle action potential amplitudes without change in the degree of conduction block. The mechanism of action of interferon-alpha is unknown, but it may modulate proinflammatory cytokines that have a role in immune-med iated demyelination. Interferon-alpha may be an effective alternative therapy in patients with CIDP who relapse or are refractory to convent ional treatments.