Zhu Wen-Jia, Da Yu-Wei, Chen Hai, Xu Min, Lu Yan, Di Li, Duo Jian-Ying
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
World J Clin Cases. 2022 Feb 16;10(5):1709-1715. doi: 10.12998/wjcc.v10.i5.1709.
This study describes the efficacy of a tacrolimus treatment regimen used to treat two patients with relapsing-remitting chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
Two patients (17-year-old female and 27-year-old male) were enrolled in the current study and were followed up for 12 mo. The first patient was administered tacrolimus (2 mg/d) for 12 mo and prednisolone (40 mg/d) for six months. The second patient was administered tacrolimus (3 mg/d) for six months. Both patients were followed up for 12 mo and the degree of recurrent weakness or normalized motor function was monitored. In addition, nerve conduction studies and tacrolimus levels were recorded. Following tacrolimus treatment, both patients showed marked improvement in clinical outcomes. In the first patient, prednisolone treatment was successfully withdrawn after six months. Sensory as well as motor nerve conduction velocities showed evident recovery following treatment. However, conduction velocities did not completely return to normal, suggesting that electrophysiological recovery can be slower than clinical recovery.
Neither patient exhibited any adverse effects due to the tacrolimus therapy. Therefore, tacrolimus can be effective for the treatment of patients with steroid-resistant CIDP.
本研究描述了一种他克莫司治疗方案用于治疗两名复发缓解型慢性炎性脱髓鞘性多发性神经根神经病（CIDP）患者的疗效。
两名患者（17岁女性和27岁男性）纳入本研究并随访12个月。第一名患者接受他克莫司（2mg/d）治疗12个月，泼尼松龙（40mg/d）治疗6个月。第二名患者接受他克莫司（3mg/d）治疗6个月。两名患者均随访12个月，监测复发肌无力程度或运动功能恢复正常情况。此外，记录神经传导研究和他克莫司血药浓度。他克莫司治疗后，两名患者临床结局均显著改善。第一名患者在6个月后成功停用泼尼松龙。治疗后感觉及运动神经传导速度均有明显恢复。然而，传导速度未完全恢复正常，提示电生理恢复可能慢于临床恢复。
两名患者均未出现他克莫司治疗相关的不良反应。因此，他克莫司对类固醇抵抗型CIDP患者可能有效。
