CIDP

CIDP is the most common chronic autoimmune neuropathy with a prevalence of 2.8/100,000. Approximately 5% of AIDP progresses to a chronic state, also called CIDP.

Clinical features develop over 2 months at least 1. progressive symmetrical proximal and distal weakness 2. Large fibre sensory loss 3. areflexia 4. Fatigue

Generally, the cranial nerves, autonomic processes, and respiratory functions are left intact.

Diagnostic Evaluation of CIDP

EMG/NCS Neuropathy bloodwork: HbA1c, CBC, lytes, liver, renal, thyroid function. B12, MMA, SPEP, UPEP, IFE, FLC analysis. LP for albuminocytologic dissociation MRI spine with Gad to evaluate for nerve root enhancement

Treatment of CIDP

As opposed to AIDP, steroids are indicated in this context. Treatment for CIDP consists of maintenance IVIg 1g/kg every 3 weeks or subcutaneous Ig, and prednisone 1 mg/kg.

Prognosis of CIDP

25% complete remission 50% require ambulatory assist devices 10% are permanently disabled