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Chronic inflammatory axonal polyneuropathy
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  • Published on:
    Chronic inflammatory axonal polyneuropathy
    • Ashutosh Tiwari, Assistant Professor, Neurology All India Institute of medical sciences, Rishikesh, India
    • Other Contributors:
      • Govind Madhaw, Senior Resident, Neurology
      • Mritunjai Kumar, Assistant Professor, Neurology

    In clinical practice, neuropathies are groups of disorders with curable, treatable, and non-treatable aetiologies, the later accounting for most of the cases.[1] Every newly identified disorder either on the basis of etiology or syndromic group responding to particular treatment brings hope for few more patients.
    This study by Shin J Oh et al [2] brings hope for some patients who were previously either classified as axonal neuropathy of undetermined cause orin the evolutionary phase of a neurodegenerative diseases (such as anterior horn cell diseases). Thus, in the absence of any evidence, such patients usually remained deprived of any immunotherapies and succumbed to the progressive disease. Now with this piece of information, it can be inferred that all those patients presenting with chronic (more than 2 months), symmetrical or asymmetrical, proximal and distal weakness without any evidence of demyelination (i.e. axonal) on nerve conduction studies and without any known secondary causes of axonal polyneuropathy could qualify for immunotherapy when nerve biopsy or CSF protein > 55 mg/dl shows evidence of inflammation. Thus, chronic inflammatory polyneuropathy syndrome would be a more apt diagnosis with two variants: demyelinating (usual Chronic inflammatory demyelinating polyneuropathy, CIDP) and axonal, much like Guillain-Barre syndrome.
    However, it can be noted that all the patients included in the study did not qualify for CIAP. There were six patients w...

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    Conflict of Interest:
    None declared.