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Research paper
Chronic inflammatory demyelinating polyradiculoneuropathy in solid organ transplant recipients: a prospective study
  1. Andoni Echaniz-Laguna1,2,
  2. Jérôme de Séze1,
  3. Jean-Baptiste Chanson1
  1. 1Département de Neurologie, Hôpitaux Universitaires, Strasbourg, France
  2. 2INSERM U692, Université de Strasbourg, Strasbourg, France
  1. Correspondence to Dr A Echaniz-Laguna, Département de Neurologie, Hôpitaux Universitaires, 67098 Strasbourg, France; andoni.echaniz-laguna{at}chru-strasbourg.fr

Abstract

Background The prevalence and outcome of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients with solid organ transplantation is unknown, and there are no guidelines for the evaluation and treatment of such patients.

Methods An 8 year long monocentric prospective study was conducted in which, in a population of 1557 solid organ transplant recipients, the characteristics of 10 consecutive patients (0.6%) who developed a syndrome that fulfilled the clinical, biological and electrophysiological criteria for definite CIDP were investigated.

Results Five patients had liver transplantation, three had kidney transplantation, one had heart transplantation and one had lung transplantation. The mean interval between transplantation and CIDP was 10 months. Six patients developed CIDP after immunosuppressive therapy dosage was decreased and were treated with intravenous immunoglobulin (IVIG) and increased dosage of immunosuppressive therapy. Four patients were treated with IVIG only. Neuropathy improved in all cases, and CIDP had a monophasic course in all patients, with no relapse observed over a mean follow-up of 5 years.

Conclusion CIDP in solid organ transplant recipients is rare, appears in the first year after transplantation, has a monophasic course and is responsive to IVIG treatment. CIDP being treatable, it should be systematically considered in solid organ transplant recipients who develop a rapidly disabling sensorimotor polyneuropathy.

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Footnotes

  • See Editorial commentary p 672

  • Competing interests JDS serves on scientific advisory boards for and has received honoraria from Biogen Idec, LFB, Merck Serono, Sanofi-Aventis and Bayer Schering Pharma, and serves on the editorial board of Revue Neurologique (Paris).

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Hôpitaux Universitaires Strasbourg institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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