Division of Neurology and Neurophysiopathology, University of Campania "Luigi Vanvitelli", Naples, Italy.
Division of Human Anatomy-Laboratory of Neuronal Networks Morphology, University of Campania "Luigi Vanvitelli", Naples, Italy.
Muscle Nerve. 2019 Dec;60(6):662-667. doi: 10.1002/mus.26669. Epub 2019 Aug 23.
Despite the well-described clinical efficacy of long-term subcutaneous immunoglobulin (LT-SCIg) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients, the neurophysiological effects of SCIg have been followed only for a short time and were not correlated with clinical parameters.
Fourteen CIDP patients were evaluated at baseline and after LT-SCIg administration for 24 to 48 months. Nerve conduction studies were performed and clinical features were assessed for: (a) overall strength, by Medical Research Council sum score; (b) sensory function, by Inflammatory Neuropathy Cause And Treatment score; (c) disability, by Rasch-built overall disability scale; (d) quality of life (QoL), by the EuroQol Visual Analog Scale.
LT-SCIg treatment improved clinical and neurophysiological features, preserving strength and improving sensory deficits, disability, and QoL. Clinical scores correlated with the amplitude of distal motor action (dCMAP) and sensory nerve action (SNAP) potentials.
LT-SCIg treatment demonstrates efficacy in maintaining and continuing clinical improvement at 24 to 48 months after start of treatment. dCMAP and SNAP amplitudes represent useful prognostic factors for functional outcome.
尽管长期皮下免疫球蛋白（LT-SCIg）在慢性炎症性脱髓鞘性多发性神经病（CIDP）患者中的临床疗效已有很好的描述，但 SCIg 的神经生理效应仅被跟踪了很短的时间，并且与临床参数没有相关性。
14 名 CIDP 患者在基线时和接受 LT-SCIg 治疗 24 至 48 个月后接受评估。进行神经传导研究，并评估以下临床特征：（a）整体力量，采用医学研究理事会总和评分；（b）感觉功能，采用炎症性神经病原因和治疗评分；（c）残疾，采用 Rasch 构建的整体残疾量表；（d）生活质量（QoL），采用欧洲五维健康量表视觉模拟评分。
LT-SCIg 治疗改善了临床和神经生理特征，保持了力量，并改善了感觉缺陷、残疾和生活质量。临床评分与远端运动动作电位（dCMAP）和感觉神经动作电位（SNAP）的振幅相关。
LT-SCIg 治疗在开始治疗后 24 至 48 个月时显示出维持和持续临床改善的疗效。dCMAP 和 SNAP 振幅是功能结局的有用预后因素。
