Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1709-1715
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1709
Tacrolimus treatment for relapsing-remitting chronic inflammatory demyelinating polyradiculoneuropathy: Two case reports
Wen-Jia Zhu, Yu-Wei Da, Hai Chen, Min Xu, Yan Lu, Li Di, Jian-Ying Duo
Wen-Jia Zhu, Yu-Wei Da, Hai Chen, Min Xu, Yan Lu, Li Di, Jian-Ying Duo, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Zhu WJ performed the study and drafted the manuscript; Chen H provided technical advice; Xu M, Lu Y and Di L collected clinical data; Da YW designed and supervised the study; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patients for publication of this case report.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Wei Da, MD, Doctor, Professor, Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. dayuwei100@hotmail.com
Received: September 23, 2021
Peer-review started: September 23, 2021
First decision: October 22, 2021
Revised: November 5, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 16, 2022
Processing time: 140 Days and 23.7 Hours
Abstract
BACKGROUND

This study describes the efficacy of a tacrolimus treatment regimen used to treat two patients with relapsing-remitting chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Chronic inflammatory demyelinating polyradiculoneuropathy; Prednisolone; Tacrolimus; Relapsing-remitting; Treatment; Case report

Core Tip: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated motor sensory neuropathy that is characterized by demyelination of the peripheral nerves and secondary axonal damage. Tacrolimus is mainly used in organ transplant patients and autoimmune diseases. Here, we investigate the efficacy of tacrolimus in two CIDP patients. Our results demonstrate the efficacy of tacrolimus treatment without significant adverse events. Therefore, tacrolimus can be used as an alternative treatment option if first line treatments are not effective or in refractory CIDP patients.