Department of Neurosciences, University of Padova, Italy.
Clin Neurophysiol. 2011 Dec;122(12):2518-22. doi: 10.1016/j.clinph.2011.05.015. Epub 2011 Jun 15.
Rituximab treatment has shown clinical improvement in anti-myelin associated glycoprotein (MAG) polyneuropathy. We analyzed scores of clinical scales and the most sensitive electrophysiological parameters before and after immunomodulating treatment with rituximab in a group of patients affected by anti-MAG demyelinating polyneuropathy.
Clinical scores, the percentage of CD20 B-lymphocytes, anti-MAG antibody titers and electrophysiological data in 7 patients with anti-MAG polyneuropathy were analyzed. The patients were examined before a cycle with rituximab, 6, 12 and 24 months after the end of the treatment. Two patients were treated with rituximab additional cycles and re-evaluated 48 months after the first treatment.
There were no evident correlation between anti-MAG serum antibody titers or clinical scales and electrodiagnostic data. Significant decrease in the proportion of CD20 B-lymphocytes was observed. Significant anti-MAG antibodies titers reduction was detected after re-treatment. At follow-up, pinprik sensation and two point discrimination presented a significant improvement compared with the score before treatment.
In our patients, rituximab did not improve any electrophysiological data. No correlation with anti-MAG serum antibodies course was found. With rituximab only pin sensibility improved.
Rituximab re-treatment significantly reduces anti-MAG serum antibodies titers but improves only small fibers sensibility.
利妥昔单抗治疗抗髓鞘相关糖蛋白（MAG）多神经病显示出临床改善。我们分析了一组抗 MAG 脱髓鞘多神经病患者在接受利妥昔单抗免疫调节治疗前后临床量表评分和最敏感的电生理参数。
分析了 7 例抗 MAG 多神经病患者的临床评分、CD20 B 淋巴细胞百分比、抗 MAG 抗体滴度和电生理数据。患者在接受利妥昔单抗治疗前一个周期、治疗结束后 6、12 和 24 个月进行检查。两名患者接受了利妥昔单抗的额外治疗周期，并在第一次治疗后 48 个月进行了重新评估。
抗 MAG 血清抗体滴度或临床量表与电诊断数据之间没有明显的相关性。观察到 CD20 B 淋巴细胞比例显著下降。再次治疗后，抗 MAG 抗体滴度显著降低。随访时，与治疗前评分相比，针刺痛觉和两点辨别觉明显改善。
在我们的患者中，利妥昔单抗并未改善任何电生理数据。未发现与抗 MAG 血清抗体病程相关。仅使用利妥昔单抗可改善小纤维敏感性。
利妥昔单抗再治疗显著降低抗 MAG 血清抗体滴度，但仅改善小纤维敏感性。
