Chronic inflammatory demyelinating polyneuropathy and psoriasis comorbidity with significantly alleviated in symptoms after secukinumab: case report

Background Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease that involves damage to the peripheral nervous system. The course of the disease can progress for more than 8 weeks, with frequent incidences of relapse-remission courses. This article reported a rare combin...

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Bibliographic Details
Published in:BMC neurology 2022-11, Vol.22 (1), p.1-400, Article 400
Main Authors: Jin, Yan, Chu, Hong, Dong, Hongjuan, Wang, Hongyang, Wang, Qingping, Zhao, Xiaoquan, Qin, Dongdong, Lu, Zuneng, Weng, Chao
Format: Article
Language:English
Subjects:
Autoantibodies
Autoimmune diseases
Case Report
Case reports
Case studies
Chronic inflammatory demyelinating polyneuropathy
Clinical outcomes
Comorbidity
Demyelination
Drug dosages
Drug therapy
Electrophysiology
Guillain-Barre syndrome
Hospitals
Immunoglobulin G
Immunoglobulin M
Immunomodulatory therapy
Inflammation
Intravenous administration
Monoclonal antibodies
Muscle strength
Nervous system
Ointments
Patients
Polyneuropathy
Propionic acid
Psoriasis
Remission
Signal transduction
Steroids
Treatment
Tumor necrosis factor-TNF
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Summary:Background Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease that involves damage to the peripheral nervous system. The course of the disease can progress for more than 8 weeks, with frequent incidences of relapse-remission courses. This article reported a rare combination of CIDP with fluctuating symptoms, recurrence-remission, and comorbidity with psoriasis. Case presentation A 29-year-old male patient with repeated limb weakness and numbness was admitted to the hospital several times in the past six months. He had a history of psoriasis for 6 years, and the medications (clobetasol propionate ointment and calcipotriol ointment) treated for psoriasis were discontinued 1 year ago. During the hospitalization, repeated intravenous injections of human immunoglobulin G (IVIg), immunoadsorption, and secukinumab were performed. Nerve electrophysiology tests, ganglioside autoantibody spectrum tests, and clinical MRC muscle strength scores were performed on a regular basis to confirm the diagnosis of CIDP. The patient was regularly followed up. Results After repeated rounds of human IVIg and immunoadsorption, the patient's MRC score was increased by [greater than or equal to] 6 points. The first ganglioside autoantibody spectrum test showed anti-GQ1b IgG ( +) and anti-GM1 IgM ( +) antibodies, and all were negative after re-examination. Finally, the patient was treated with the IL-17A inhibitor secukinumab for psoriasis. During 7 months of follow-up, the CIDP and psoriasis symptoms are relatively stable. Conclusion Combination of IVIg and immunoadsorption was highly effective in treating CIDP complicated with psoriasis. The clinical manifestations of CIDP are diverse. When relapse-remission occurs in the course of the disease, it is necessary to clarify whether it is combined with other autoimmune diseases and should control the autoimmune diseases as soon as possible. Keywords: Chronic inflammatory demyelinating polyneuropathy, Psoriasis, Immunomodulatory therapy, Treatment, Case report
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-022-02928-3