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Myasthenia CIDP MS


Welcome to the  Rheumatic section of the CIDPUSA Foundation  

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Intravenous immune globulin (IVIG) has also been found to be beneficial.  It remains the cornerstone of CIDP treatment. IVIG is usually given in divided doses over 4 or 5 consecutive days at a  total dose of 2g/kg. Dr. Dalakas has shown that if the total infusion can be given in two large doses it works better for the patient. He also recommends that for all the neurological disorders the dose of IVIg should be 2gm/kg.

 Maintenance doses are often needed at monthly intervals to maintain clinical response. Serious side effects of IVIG treatment are rare, (fatal anaphylaxis in IgA-deficient patients seen in { In patients who have anti IgA  antibodies}.  We recommend that before the infusion the total IgA level be measured. If the level is below 58 then anti IgA ANTIBODIES NEED TO BE MEASURED. However a case has been reported with IgA LEVEL of 58 who later developed IgA reaction. So a careful history should be taken of all patients first starting IVIg.

 Also if the lab reports IgA <20 IT MAY BE SAFE TO ASSUME THAT IT IS ZERO.

 Potential nephrotoxicity, especially in patients with pre-existing renal disease.

For those that are resistant to IVIg therapy one needs to check if the dose being given is correct. If the dose has been 2g/kg then one can consider adding steroids to the IVIg. If that does not work then Cyclophosphamide, Rituxan, Cyclosporin can be considered.

IVIg is used as a rescue therapy or first line agent and then a second line agent is started like cyclosporin. In time this becomes the agent of choice for chronic maintenance.

Questions. Why do some people get autoimmune disease?

The people who get autoimmune diseases have immune systems that overreact to environmental toxins and  may be suffering from immune deficiency  (IgG sub class deficiency). They may have developed autoantibodies,( antibodies against self). Not all the people with autoantibodies get autoimmune disease. Due to injury their protected proteins may get exposed to their immune system which starts producing autoantibodies.

Questions. Which Sex gets more autoimmune diseases?

Women get the autoimmune diseases much more than men. Almost three times more. When the man gets past age 30 he also starts getting more autoimmune diseases, due to a deficiency.

C.I.D.P. is the only disease men get more frequently than women.

Questions. When is a good time to get treatment for autoimmune diseases?

The best time is as soon as possible.

Treatment only needs to be given in a attack phase, during the remission expensive treatments like IVIg are not used.

Questions. What should be the first line of treatment?

We recommend that antibiotics should be the first line of treatment. For every disease there is a specific antibiotic, fully explained in our E-Book.

Questions. Does the CIDP site help getting appointments with specific doctors?

Yes we will suggest who to see to get help. You can also get help by writing to us about your problems and we can tell you what you have. There will be  a small charge. This saves you a lot of time and money..

Questions. Does CIDP site assist in getting home IVIg ?

Yes we make referrals.

Questions.Will the muscle weakness continue to deteriorate?

Improves with anti-inflammatory treatment like IVIG, prednisone........

Questions. What are treatment options?

IVIG, plasmapheresis, Prednisone, Cytoxan, rituxan, remicade, Imuran, cyclosporin,enbral

 Questions. Will steroids control the symptoms?

Yes it takes about  60days but watch out for weight gain, cataracts, stomach ulcers, osteoporosis, depression, anger outbursts, proximal muscle weakness., hip fractures......

Questions. What are the side effects of these drugs?

Steroids have the most side effects  look above, read about the IVIg side effects in the IVIG section.

 Questions. Would plasma exchange help?

Yes for a short time. Thus has to be repeated.

Questions. What is the long-term outlook?

If treatment is started early its good.

Questions. I am in a remission phase do I need treatment?

General answer is no. Some people may need treatment to maintain their condition so they do not get a relapse.

 Questions. I have CIDP what is my future outlook regarding this disease?

In the past some of these patients would be wheelchair bound. With modern treatments they have led active lives.

Questions. I have AUTOIMMUNE DISEASE , what is the best reading guide for me and my family.?


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