Pulse steroids for cidp

My neuro. has had me on pulse steroids since the beginning. When I was first dx’d. he tried IVIG but that didnt seem to work so he put me on a regimin of 500mg. solumedrol via iv twice a week, then after 2 months switched me over to 500 mg methylprednisilone twice a week and is now trying to ween me down slowly, am now doing 320mg twice a week with his goal being to ween me down to just under 200mg twice a week sometime in july, which is when I see him again. The side effects are starting to pile up, mainly weight gain, moon face and sometimes horrible insomnia but the trade off is that in 7 months time I am back to about 85 to 90% of my pre CIDP abilities, so I guess that the trade off is worth it…at least so far.

Yes – there’s a lot of buzz about this treatment, particularly on the MS message boards. As of right now, I believe you have to go to Hopkins to participate in the trial, although I believe Rush Medical Center in Chicago will soon also be a site. Evidently, Hopkins is very selective regarding the applicants allowed into the trial, selecting patients they believe are going to be the most responsive to the treatment. For instance, as of right now, for MS, they are limiting the protocol to MS patients with the relapsing/remitting form of MS, not progressive forms. However, there are promising results thus far.

It has been suggested that sialylated Fc fragments may not directly interact with Fc γ Rs on effector cells, as they show reduced affinity, but that they may modulate inflammatory activity by binding to SIGN-R1 (ICAM-3 adhesion molecule) expressed on regulatory macrophages leading to the release of soluble mediators. These mediators would then bind to effector macrophages increasing the expression of inhibitory Fc γ RIIB which would eventually outcompete activating Fc γ Rs, increasing the number of immune complexes needed to trigger an inflammatory response [ 39 , 54 ]. Immunomodulation by glycosylation leads to further considerations on the complex environmental regulation of immune responses and weakens those hypotheses based on simple IgG-Fc γ R and IgG-FcRn interactions. However many of these considerations have been derived from studies on animal models and must still be validated for humans. In spite of the fragmentary understanding of IVIg anti-inflammatory activity, immune globulin is successfully used in several autoimmune and inflammatory conditions including CIDP [ 55 ]. As already observed for steroids, response to treatment is often variable and this may be linked to genetic differences in immune system regulation [ 56 ] as well as glycosylation patterns in IVIg preparations.

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Pulse steroids for cidp

pulse steroids for cidp

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