Clinical manifestations of chronic inflammatory demyelinating polyneuropathy with anti-cardiolipin antibodies

Objective – Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune syndrome where certain autoantibodies define clinicopathologic subgroups. In the present study, serum anti-cardiolipin antibodies (aCL) were evaluated. Materials and methods – We investigated aCL in sera from 21 patients diagnosed with CIDP in our hospital between 1991 and 2001. The four CIDP patients with aCL (aCL+) were compared with 17 patients without aCL (aCL−). Results – All aCL+ patients displayed sensory-motor polyneuropathy, with severity and distribution of weakness resembling those in aCL− patients. Anti-nuclear antibody titer of aCL+ patients were significantly higher than those in aCL− patients. None of aCL+ patients presented clinical manifestations of primary anti-phospholipid syndrome (APS), such as thromboses or recurrent abortion. Although the aCL+ patients were older and had more complications and more severe pathologic features than aCL− patients, they responded well to steroid pulse or intravenous immunoglobulin. Conclusion – The aCL in CIDP apparently differ from ‘autoimmune’ aCL in APS, instead being among the autoantibodies pathologically involved in CIDP subgroups.