Pulse oral corticosteroids in pediatric chronic inflammatory demyelinating polyneuropathy

Muscle Nerve. 2020 Dec;62(6):705-709. doi: 10.1002/mus.27058. Epub 2020 Oct 2.

Abstract

Childhood onset chronic inflammatory demyelinating polyneuropathy (CIDP) often requires long-term immunomodulatory therapy. We report a comprehensive review of our treatment of pediatric CIDP with a focus on high-dose weekly corticosteroids ("pulse oral corticosteroids"), a treatment method that is not commonly reported. We retrospectively reviewed medical records of pediatric patients with CIDP treated at our center between 2000 and 2018 for whom we had at least 12 mo follow-up. Here, we describe the demographics, disease course, treatment regimens, and long-term outcomes of these patients. Twenty-five patients were identified for analysis. Pulse oral corticosteroid monotherapy was the predominant maintenance treatment in 56% of patients. Patients were followed for a median of 4 y. Side effects were seen in a minority of patients. The probability of a normal exam or being off treatment at last follow-up was similar regardless of predominant maintenance therapy. Pulse oral corticosteroid therapy is a safe and effective long-term treatment option in children with CIDP.

Keywords: CIDP; corticosteroids; immunomodulatory therapy; inflammatory neuropathy; pediatric CIDP.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Child
  • Child, Preschool
  • Duration of Therapy
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Infant
  • Irritable Mood
  • Maintenance Chemotherapy
  • Male
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology
  • Prednisone / administration & dosage*
  • Pulse Therapy, Drug
  • Sleep Initiation and Maintenance Disorders / chemically induced
  • Weight Gain
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Prednisone