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A difficult case
Refractory CIDP with chronic lymphocytic leukaemia responding to chemoimmunotherapy
  1. Dana Lewis1,
  2. Chinar Osman2,
  3. David Allen2,
  4. Ashwin Arnold Pinto2,
  5. Andrew Duncombe3,
  6. Haider A Katifi2
  1. 1 Department of Medicine, Southampton University Hospitals NHS Trust, Southampton, UK
  2. 2 Wessex Neurological Centre, Southampton University Hospitals NHS Trust, Southampton, UK
  3. 3 Department of Haematology, Southampton University Hospitals NHS Trust, Southampton, UK
  1. Correspondence to Dr Chinar Osman, Wessex Neurological Centre, Southampton University Hospitals NHS Trust, Southampton, Southampton, UK; chinar.osman{at}uhs.nhs.uk

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) has a variable clinical course with 15% remaining refractory to treatment. We report a woman with severe refractory CIDP and coexisting chronic lymphocytic leukaemia (CLL) who improved dramatically after chemoimmunotherapy appropriate for the CLL, including rituximab. A subsequent CIDP relapse after 15 months responded again to similar treatment, and the improvement has been maintained with 3-monthly rituximab infusions as sole ongoing therapy. The case suggests that CIDP refractory to conventional treatment may have associated pathology, in this case haematological malignancy, and that treating the malignancy can effectively treat the CIDP.

  • neuroimmunology
  • haematology
  • neurophysiology

https://doi.org/10.1136/practneurol-2020-002672

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    Footnotes

    • Contributors DL, CO, AD and HAK wrote the draft manuscript. DA wrote the neurophysiology section. AAP was involved in conception of the work. AD, HAK and AAP revised and reviewed the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned. Externally peer reviewed by Gareth Llewelyn, Cardiff, UK.

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