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CIDP — SCE Neurology MCQ

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HardNeuromuscularCIDPSCE Neurology

A patient with established CIDP responds to intravenous immunoglobulin but has recurrent end-of-dose weakness and difficult venous access. Which maintenance option can provide immunoglobulin at home after specialist review?

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Correct answer: C — Regular subcutaneous immunoglobulin maintenance therapy

The best answer is “Regular subcutaneous immunoglobulin maintenance therapy”. Subcutaneous immunoglobulin is an established maintenance option for immunoglobulin-responsive CIDP and can reduce venous-access burden; dose and training are individualised by the specialist neuromuscular service. The alternatives “Continue repeated high-dose corticosteroid pulses indefinitely”, “Switch to plasma exchange as routine home maintenance”, “Use pyridostigmine as maintenance for demyelinating neuropathy”, “Stop immunoglobulin despite reproducible end-of-dose deterioration” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/