Multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) is a variant of chronic inflammatory demyelinating polyneuropathy (CIDP). It presents as a chronic, asymmetrical sensory-motor polyneuropathy with features of demyelination on nerve conduction studies. Management options include intravenous immunoglobulin and corticosteroid infusions. Prognosis is generally favorable but there have been reports of variable response to treatment. This condition is rare and local data on CIDP and its variants is limited, hence we report a case of a 64-year-old male presenting with 3 year history of progressive asymmetric numbness and weakness of all limbs. Sensory deficits began on the left hand and had progressed to involve the distal portions of all limbs, eventually developing weakness as well. The patient underwent multiple nerve-conduction studies, all of which showed findings congruent with MADSAM. He was given intravenous high dose methylprednisolone and was maintained on mycophenolate mofetil.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Methylprednisolone ; Mycophenolate Mofetil ; Mycophenolic Acid

OBJECTIVE: This paper describes the clinical experience in Filipinopatients with lupus nephritis who had used mycophenolate mofetil (MMF). METHODS: Retrospective case-cohort. Patients were obtained from database of Filipino patients who received MMF for lupus nephritis from January 2003 to June 2006. Data obtained included demographics, renal parameters including histology, SLE disease activity measures, corticosteroid dose and prior immunosuppressive drugs, dose, and duration of MMF, and adverse drug events. The attending rheumatologists assessed their patients' individual response to MMF treatment. RESULTS: There were 39 Filipino patients with lupus nephritis who had received MMF, of whom 97.4% were females. The mean age was 30.89 years. Of the 25 patients who had undergone renal biopsy, 4.0% had World Health Organization (WHO) Class II, 12.0% had Class II, 64% had class IV, and 24% had Class V. Mean dose of MMF was 1.2g/day with a mean duration of treatment of 14.77+_10.7 months. Mycophenolate mofetil was used as induction therapy in 8 patients and to maintain remission in 31 patients. Clinical response was improved in 21 patients, stable in 11 patients and worse in 7 patients. Adverse events were reported in 11 patients and were commonly gastrointestinal-related. SUMMARY: This clinical experience among Filipinos with SLE reiterates MMF as a reasonable option in lupus nephritis, with acceptable safety profile. Cognizant of the heterogeneity of individual clinical response to drug, it will be useful to further study the variables which may influence such treatment responses.

Human ; Mycophenolate Mofetil ; Lupus Nephritis