2017 年 34 巻 3 号 p. 178-181
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.
