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Chronic inflammatory demyelinating polyneuropathy (CIDP) is characterised by the occurrence of symmetrical weakness and sensory impairment in arms and legs. The course is relapsing or chronic and progressing. CIDP is considered to be an autoimmune disease, which is supported by the beneficial response to immunomodulating therapies in most patients.1 Benefit from treatment with corticosteroids, plasmapheresis and intravenous immunoglobulin (IVIG) has been confirmed1 but not all patients respond. Beneficial effects in previously treatment resistant CIDP have been reported for ciclosporin, etanercept, mycophenolate mofetil, rituximab and pulse cyclophosphamide treatment.1 In 2002, Brannagan et al2 reported long term remission after high dose cyclophosphamide in four patients with CIDP refractory to conventional treatment. The same year Vermeulen and Van Oers3 reported on successful autologous blood stem cell transplantation (ASCT) in one patient with CIDP. To our knowledge, no reports exist on repeated treatment with high dose cyclophosphamide and/or ASCT in CIDP.
We report on a patient with CIDP who has been in remission for more than 3 years after treatment with high dose cyclophosphamide and ASCT on two occasions.
A 56-year-old man presented at his local hospital in August 2001 with a history of progressive weakness in his arms …