Idiopathic inflammatory polyradiculoneuropathy: evaluation of clinical and laboratory data and therapeutic considerations

The clinical, immunological and neurophysiological data on 54 patients with idiopathic inflammatory polyradiculoneuropathy (IIP) are reviewed in order to reach a correct diagnostic and therapeutic approach. 49 of these patients presented acute and 5 recurrent IIP. Of the acute cases 10 patients had a severe course with paralysis of all limbs and respiratory insufficiency, and 3 died. An increase in CSF total proteins and impairment of nerve motor conduction velocities proved to be valuable tests for the diagnosis of IIP; these tests usually become more significant after 2 or 3 weeks of illness. Steroid treatment did not prove to be effective, while two patients with acute and progressive IIP, subjected to plasmapheresis, showed rapid and steady improvement. In these two patients the plasmapheresis was associated with azathioprine.