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• Vol.52 No.3
• CLINICA NEUROL, 52: 172−177, 2012
• Vol.52 No.3 contents

Case Report

Successful cyclosporine treatment in 2 patients with refractory CIDP, involving monitoring of both AUC_0-4h and trough levels

Akiko Takeuchi, M.D.¹⁾³⁾, Shinichi Shirai, M.D.¹⁾, Kazuhiro Horiuchi, M.D.¹⁾, Ikuko Takahashi, M.D.¹⁾, Masaaki Matsushima, M.D.¹⁾, Makoto Hirotani, M.D.¹⁾, Takahiro Kano, M.D.¹⁾, Ichiro Yabe, M.D.¹⁾, Akihisa Matumoto, M.D.²⁾⁴⁾ and Hidenao Sasaki, M.D.1)

¹⁾Department of Neurology, Hokkaido University Graduate School of Medicine
²⁾Department of Neurology, Sapporo City General Hospital
³⁾Present Address: Department of Neurology, Nakamura Memorial Hospital
⁴⁾Present Address: Jozankei Hospital

Cyclosporine A (CYA) treatment has been reported to be probably useful for patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) that is resistant to conventional treatment. Although several studies have shown that appropriate area under the concentration-time curve (AUC) monitoring of CYA levels results in improved outcomes for refractory nephrotic syndrome patients, the importance of using AUC analysis for CIDP remains unclear. In this study, we measured both trough and AUC from 0 to 4 h (AUC_{0-4 h}) levels of CYA in 2 patients with CIDP and compared the findings for the clinical parameters. On the basis of the CYA dosing recommendations for patients with nephrotic syndrome, we used a CYA concentration of 150 ng/ml for the trough level and an AUC_{0-4 h} value of 2,500 ng/(ml･h). Patient 1 showed a significant increase in grip strength and a prolonged remission period. Patient 2 showed improvement in the modified Rankin scale and manual muscle test (MMT) scores. Monitoring both AUC_{0-4 h} and trough levels of CYA seems to be a better option than monitoring the trough level alone because it leads to improved estimation of the efficacy and safety of CYA treatment in the case of CIDP patients.
Full Text of this Article in Japanese PDF (478K)

(CLINICA NEUROL, 52: 172−177, 2012)
key words: chronic inflammatory demyelinating polyneuropathy, cyclosporine, area under the blood concentration-time curve

(Received: 2-Oct-11)