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Original research
Chronic inflammatory axonal polyneuropathy
  1. Shin J Oh1,
  2. Liang Lu2,
  3. Mohammad Alsharabati1,
  4. Marla B Morgan2,
  5. Peter King1
  1. 1Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2Birmingham, Alabama, USA
  1. Correspondence to Dr Shin J Oh, Neurology, University of Alabama, Birmingham, AL 35294, USA; shinjoh{at}


Objectives Chronic inflammatory axonal polyneuropathy (CIAP) is defined on the basis of the clinical, electrophysiological and nerve biopsy findings and therapeutic responses of ‘immunotherapy responding chronic axonal polyneuropathy (IR-CAP)’.

Methods The diagnosis of IR-CAP was made when all of three of the following mandatory criterion were met: (1) acquired, chronic progressive or relapsing symmetrical or asymmetrical polyneuropathy with duration of progression >2 months; (2) electrophysiological evidence of axonal neuropathy in at least two nerves without any evidence of ‘strict criteria of demyelination’; and (3) definite responsiveness to immunotherapy.

Results Thirty-three patients with IR-CAP showed similar clinical features of chronic inflammatory demyelinating polyneuropathy (CIDP) except ‘motor neuropathy subtype’. High spinal fluid protein was found in 27/32 (78%) cases. ‘Inflammatory axonal neuropathy’ was proven in 14 (45%) of 31 sural nerve biopsies.

Discussions IR-CAP could well be ‘axonal CIDP’ in view of clinical similarity, but not proven as yet. Thus, IR-CAP is best described as CIAP, a distinct entity that deserves its recognition in view of responsiveness to immunotherapy.

Conclusion Diagnosis of CIAP can be made by additional documentation of ‘inflammation’ by high spinal fluid protein or nerve biopsy in addition to the first two diagnostic criteria of IR-CAP.

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  • Original reference Presented at 2005 American Academy of Neurology Meeting. Lu L, Claussen GC, Morgan MB, Oh SJ. Chronic inflammatory axonalpolyneuropathy: A CIDP variant or a distinct entity? Neurology;64(Suppl 1):A378, 2005.

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  • Correction notice This article has been corrected since it appeared Online First. References 6, 7, 9, 26, 27, author initials have been corrected to Oh SJ.

  • Contributors Every one of authors contributed patients during their tenure at the University of Alabama at Birmingham and participated in formulating the this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study is approved by the University of Alabama at Birmingham IRB (190425).

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

  • Data availability statement Data are available upon reasonable request. Summarised data are available from the first author upon reasonable request.

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