Monitoring
Depending on the severity of the disease, follow-up may need to be from once monthly to every 3-6 months to measure improvement in strength. Follow-up visits should address functional difficulties due to weakness or gait difficulty, as well as complications of treatment.
Repeat nerve conduction studies are usually not helpful because abnormalities may persist even after clinical improvement. However, if new signs or symptoms develop, repeat nerve conduction studies may show deterioration if there is a relapse. In addition, an increase in the total number of demyelinating features or the development of new demyelinating features following repeat studies may signal an increased risk of relapse after discontinuation of intravenous immunoglobulin.[174]
Comparisons of serial nerve ultrasound results can be useful to assess response to treatment in patients with CIDP, as a reduction in nerve size can suggest effective therapy. Patients with active CIDP that is refractory to treatment will generally have nerves that are enlarged, or nerves that have remained enlarged without significant change over time.[56] However, larger studies are needed before this approach is used routinely in management.
Patients on immunosuppressants should have routine full blood count and metabolic panels to look for leukopenia, thrombocytopenia, anaemia, electrolyte abnormalities, hepatic failure, or renal insufficiency.
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