2023 Volume 40 Issue 1 Pages 43-49
Objective : To clarify the effectiveness of combination therapy of prednisolone (PSL) and immunosuppressive drugs in the acute phase of peripheral neuropathy associated with eosinophilic granulomatosis with polyangiitis (EGPA).
Methods : Twenty–four patients with EGPA and peripheral neuropathy who were diagnosed between April 1999 and March 2019 were enrolled in the study. We retrospectively analyzed the changes in muscle strength and electrophysiological parameters between the time before and one year after the treatment. The changes after the treatment were compared between patients with only corticosteroid hormone and patients with intensified treatment of corticosteroid hormone and immunosuppressive drugs.
Results : In both patient groups, we found significant improvements in the compound muscle action potential amplitude of the tibial nerve and strength of the tibialis anterior and gastrocnemius muscles, whereas the sensory nerve action potentials of the sural nerve showed significant decreases in amplitude. There were no significant differences in the effect of treatment between the patient groups with only corticosteroid hormone therapy and intensified therapy with immunosuppressive drugs.
Conclusion : The initial intensified therapy with immunosuppressive drugs might not have additional effects on corticosteroid hormone one year after the acute phase of EGPA with peripheral neuropathy. Sural nerve SNAP decreased over time, contrary to the recovery of muscle strength, and may reflect residual sensory symptoms that persist after treatment.
