Modified method of intravenous immunoglobulin administration for patients with intractable multifocal motor neuropathy: A case report

Akihiro Mukaino*, Atsushi Nagaoka, Shunsuke Yoshimura, Hideki Nakajima, Hirokazu Shiraishi, Masakatsu Motomura, Miyuki Morikawa, Susumu Kusunoki, Shunya Nakane, Yukio Ando, Akira Tsujino

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

抄録

Background: We report a case of a 64-year-old Japanese man who was diagnosed with definite multifocal motor neuropathy and successfully treated with administration of intravenous immunoglobulin (IVIg) spread over two separate weeks. Case presentation: After IVIg administration (30 g/day, five consecutive days), motor function was improved, but it was not possible to maintain the muscle strength just a few months after treatment. Although plasma exchange and cyclosporine were combined, the patient developed muscle weakness just 2 weeks after initial IVIg treatment. His grip strength decreased to 0 kg, proximal upper-limb muscle strength reduced to 2/5 according to manual muscle testing, and muscle weakness developed in the proximal lower limb muscle. We modified IVIg administration protocol from five consecutive days to two separate weeks: 3 days in the first week and 2 days in the third week without changing the total dose per month. After initiation of divided IVIg protocol, muscle weakness dramatically improved, and muscle power could be kept normal. Corrected optical density value of immunoglobulin M antibodies against GM1 elevated in the all clinical course did not correlate with muscle strength improvement. Serum immunoglobulin G levels became stable in ≥2000 mg/dL, and were associated with muscle strength improvement. Conclusion: Administration of IVIg over two separate weeks might be a treatment option in intractable patients with multifocal motor neuropathy.

本文言語英語
ページ(範囲)141-145
ページ数5
ジャーナルClinical and Experimental Neuroimmunology
8
2
DOI
出版ステータス出版済み - 2017/05

ASJC Scopus 主題領域

  • 神経科学(その他)
  • 免疫学
  • 免疫学および微生物学(その他)
  • 臨床神経学

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