CIDP Diagnostic Tools and Guidelines Quiz
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Questions and Answers

What is the recommended diagnostic tool to support the clinical diagnosis of typical CIDP and CIDP variants?

  • Nerve biopsy
  • CSF analysis
  • MRI
  • Electrodiagnosis (nerve conduction studies) (correct)

    • What is the suggested objective response to treatment with immunomodulatory agents that supports the clinical diagnosis of CIDP?

  • Worsening of symptoms
  • No response to treatment
  • Objective improvement in symptoms (correct)
  • Subjective improvement in symptoms

    • When is it suggested to use ultrasound to diagnose CIDP in adult patients?

  • For all patients with clinical suspicion of CIDP
  • For patients fulfilling diagnostic criteria for possible CIDP (correct)
  • For patients fulfilling diagnostic criteria for CIDP
  • For patients who have undergone nerve biopsy

    • When is it suggested not to use MRI to diagnose CIDP in adult patients?

    <p>For patients fulfilling diagnostic criteria for CIDP</p> Signup and view all the answers

    What suggests that CIDP may be more likely on T2 weighted MRI sequences?

    <p>Enlargement and/or increased signal intensity of nerve root(s)</p> Signup and view all the answers

    When is it suggested not to perform CSF analysis?

    <p>For patients fulfilling diagnostic criteria for CIDP</p> Signup and view all the answers

    When is it suggested to perform nerve biopsy to diagnose CIDP?

    <p>Only in specific circumstances</p> Signup and view all the answers

    What is strongly advised to test for in adult patients with a clinical suspicion of CIDP?

    <p>Serum monoclonal proteins</p> Signup and view all the answers

    What is suggested to consider testing for in all patients with clinical suspicion of CIDP?

    <p>Nodal and paranodal antibodies</p> Signup and view all the answers

    What is the best corticosteroid regimen for treatment of CIDP?

    <p>Not known</p> Signup and view all the answers

    What is the usual total IVIg dose for induction treatment in CIDP?

    <p>2 g/kg</p> Signup and view all the answers

    What medication is advised to use after failure of proven effective treatments or as add-on medication for CIDP?

    <p>Azathioprine</p> Signup and view all the answers

    What is the recommended diagnostic tool to support the clinical diagnosis of typical CIDP and CIDP variants?

    <p>Electrodiagnosis (nerve conduction studies)</p> Signup and view all the answers

    What is the recommended treatment for CIDP?

    <p>IVIg</p> Signup and view all the answers

    What is the suggested treatment for maintenance in CIDP?

    <p>SCIg</p> Signup and view all the answers

    What is the usual total IVIg dose for induction treatment in CIDP?

    <p>2 g/kg</p> Signup and view all the answers

    What is the recommended test for adult patients with a clinical suspicion of CIDP?

    <p>Serum monoclonal proteins</p> Signup and view all the answers

    When is nerve biopsy recommended to diagnose CIDP?

    <p>Only in specific circumstances</p> Signup and view all the answers

    What is the recommended treatment with corticosteroids?

    <p>The best regimen is not known</p> Signup and view all the answers

    What is the suggested diagnostic tool to diagnose CIDP in patients fulfilling diagnostic criteria for possible CIDP but not for CIDP?

    <p>Ultrasound</p> Signup and view all the answers

    What is the suggested treatment for CIDP after failure of proven effective treatments or as add-on medication?

    <p>Azathioprine</p> Signup and view all the answers

    What is the recommended treatment for induction in CIDP?

    <p>IVIg</p> Signup and view all the answers

    What is the suggested dose adjustment during follow-up for CIDP treatment?

    <p>Tailored according to individual treatment response</p> Signup and view all the answers

    What is the suggested treatment against using SCIg for induction treatment in CIDP?

    <p>Strongly recommended</p> Signup and view all the answers

    Study Notes

    Diagnostic Tools for CIDP

    • Electroneurography (ENG) and nerve conduction studies (NCS) are the recommended diagnostic tools to support the clinical diagnosis of typical CIDP and CIDP variants.
    • Ultrasound is suggested to be used to diagnose CIDP in adult patients with unclear or inconclusive ENG/NCS results.

    Response to Treatment

    • A significant improvement in at least two of the following: INCAT score, Medical Research Council sum score, and compound muscle action potential amplitudes, is suggested as an objective response to treatment with immunomodulatory agents that supports the clinical diagnosis of CIDP.

    MRI and CSF Analysis

    • High-signal intensities on T2 weighted MRI sequences suggest that CIDP may be more likely.
    • MRI is not suggested to be used to diagnose CIDP in adult patients with a clinical suspicion of CIDP and normal ENG/NCS results.
    • CSF analysis is not suggested to be performed in patients with a typical clinical presentation and ENG/NCS results consistent with CIDP.

    Nerve Biopsy

    • Nerve biopsy is suggested to be performed to diagnose CIDP in patients with a clinical suspicion of CIDP, but unclear or inconclusive ENG/NCS results, and/or if other diagnostic tests are normal.

    Laboratory Tests

    • Anti-ganglioside antibodies are strongly advised to be tested for in adult patients with a clinical suspicion of CIDP.
    • Anti-neurofascin antibody and anti-contactin antibody are suggested to be considered testing for in all patients with clinical suspicion of CIDP.

    Treatment of CIDP

    • Corticosteroids, such as prednisone, are the recommended treatment for CIDP, with a suggested regimen of 1-2 mg/kg/day for 2-4 weeks.
    • The usual total IVIg dose for induction treatment in CIDP is 2g/kg divided over 2-5 days.
    • Azathioprine is advised to be used after failure of proven effective treatments or as add-on medication for CIDP.
    • Maintenance treatment with corticosteroids or IVIg is suggested, with dose adjustment based on the patient's response and adverse effects.

    Other Recommendations

    • SCIg is not suggested to be used for induction treatment in CIDP due to the risk of severe side effects.

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    Description

    Test your knowledge on the recommended diagnostic tools and guidelines for Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). Questions cover the use of diagnostic tools like ultrasound, MRI, and CSF analysis, as well as the suggested response to treatment with immunomodulatory agents.

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