Long-term treatment of Lewis-Sumner syndrome with subcutaneous immunoglobulin infusions

J Neurol Sci. 2013 Jan 15;324(1-2):53-6. doi: 10.1016/j.jns.2012.09.033. Epub 2012 Oct 23.

Abstract

Lewis-Sumner syndrome (LSS, synonymous multifocal acquired demyelinating sensory and motor neuropathy, MADSAM) is a dysimmune peripheral neuropathy responding to corticosteroids and intravenous immunoglobulins (IVIG) in the majority of patients. We report on the long term treatment (37 and 46months respectively) of two LSS patients, who had initially responded to IVIG, with subcutaneous immunoglobulins (SCIg). Both were switched to SCIg since stabilization by IVIG could only be achieved with short treatment intervals, and one of them also suffered from recurrent transient ischemic attacks (TIAs) following IVIG related increased blood viscosity. Long-term use of SCIg was safe and well tolerated. Both patients were clinically stable with only mild to moderate fluctuations requiring SCIg dosage adaptions. No further ischemic events occurred, when the patient was switched to SCIg.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Viscosity
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / adverse effects
  • Immunoglobulins, Intravenous / therapeutic use*
  • Injections, Intravenous
  • Injections, Subcutaneous
  • Ischemic Attack, Transient / complications
  • Male
  • Middle Aged
  • Muscle Weakness / etiology
  • Neural Conduction / physiology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy*
  • Sensation Disorders / etiology

Substances

  • Immunoglobulins, Intravenous