%0 Journal Article
%A Querol, Luis
%A Rojas-García, Ricard
%A Diaz-Manera, Jordi
%A Barcena, Joseba
%A Pardo, Julio
%A Ortega-Moreno, Angel
%A Sedano, Maria Jose
%A Seró-Ballesteros, Laia
%A Carvajal, Alejandra
%A Ortiz, Nicolau
%A Gallardo, Eduard
%A Illa, Isabel
%T Rituximab in treatment-resistant CIDP with antibodies against paranodal proteins.
%D 2015
%U http://hdl.handle.net/10668/2063
%X OBJECTIVETo describe the response to rituximab in patients with treatment-resistant chronic inflammatory demyelinating polyneuropathy (CIDP) with antibodies against paranodal proteins and correlate the response with autoantibody titers.METHODSPatients with CIDP and IgG4 anti-contactin-1 (CNTN1) or anti-neurofascin-155 (NF155) antibodies who were resistant to IV immunoglobulin and corticosteroids were treated with rituximab and followed prospectively. Immunocytochemistry was used to detect anti-CNTN1 and anti-NF155 antibodies and ELISA with human recombinant CNTN1 and NF155 proteins was used to determine antibody titers.RESULTSTwo patients had a marked improvement; another patient improved slightly after 10 years of stable, severe disease; and the fourth patient had an ischemic stroke unrelated to treatment and was lost to follow-up. Autoantibodies decreased in all patients after rituximab treatment.CONCLUSIONSRituximab treatment is an option for patients with CIDP with IgG4 anti-CNTN1/NF155 antibodies who are resistant to conventional therapies.CLASSIFICATION OF EVIDENCEThis study provides Class IV evidence that rituximab is effective for patients with treatment-resistant CIDP with IgG4 anti-CNTN1 or anti-NF155 antibodies.
%K Corticoesteroides
%K Anticuerpos
%K Anticuerpos monoclonales de origen murino
%K Autoanticuerpos
%K Contactina 1
%K Ensayo de inmunoadsorción enzimática
%K Humanos
%K Inmunoglobulina G
%K Inmunoglobulinas intravenosas
%K Inmunohistoquímica
%K Perdida de seguimiento
%K Polirradiculoneuropatía crónica inflamatoria desmielinizante
%K Accidente cerebrovascular
%~