Progressive muscle weakness after high-dose steroids in two children with CIDP

Rostasy, Kevin M; Diepold, Katharina; Buckard, Johannes; Brockmann, Knut; Wilken, Bernd; Hanefeld, Folker

doi:10.1016/S0887-8994(03)00222-4

« Previous Next »Pediatric Neurology
Volume 29, Issue 3 , Pages 236-238, September 2003

Progressive muscle weakness after high-dose steroids in two children with CIDP

Kevin M Rostasy, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.
- Communications should be addressed to: Dr. Rostasy; Pediatric Neurology; Georg-August-University of Göttingen; Robert-Koch-Strasse 40; 37075 Göttingen, Germany.
Katharina Diepold, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.
Johannes Buckard, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.
Knut Brockmann, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.
Bernd Wilken, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.
Folker Hanefeld, MD
- Department of Pediatrics and Neuropediatrics, Georg-August-Universität Göttingen, Göttingen, Germany.

Received 17 December 2002; accepted 17 March 2003.

Abstract

Corticosteroids and intravenous immunoglobulins belong to the first line of treatment in chronic inflammatory demyelinating polyneuropathy. In patients with a progressive course, plasma exchange and immunomodulatory drugs are added to the regimen. To reduce the side effects of long-term oral prednisolone, high-dose pulsatile intravenous methylprednisolone treatment has been advocated. We report two children with chronic inflammatory demyelinating polyneuropathy who, after high-dose intravenous pulsatile methylprednisolone, experienced a significant clinical deterioration with profound loss of muscle strength. Both patients improved after changing treatment to immunoglobulins in one and cyclosporine combined with immunoglobulins and oral prednisolone in the other.