OBJECTIVE

To characterize clinical phenotypes of CIDP with NP, identify possible associations between NP and laboratory parameters, and assess efficacy of pathogenetic and symptomatic therapy.

MATERIAL AND METHODS

A retrospective-prospective study included 158 patients with CIDP (2021 EAN/PNS criteria). Patients were divided into groups with and without NP, as well as further subcategorized by the timing of NP onset (at disease manifestation or during progression).

RESULTS

Neuropathic pain was identified in 64 (40.5%) patients with CIDP. In the NP group, females predominated (male/female ratio=1.21), whereas males were predominant in the non-NP group (male/female ratio = 0.57). There were significant differences in phenotypic structure of CIDP between patients with NP at disease onset, NP following disease progression and those without NP. Sensory variant of CIDP was more frequently associated with NP (50% of cases), while motor phenotype was less commonly associated with pain (6.25% of cases). In all patients with sensory variant of CIDP, NP was the first symptom of disease (n=27). We first analyzed transformation of CIDP phenotypes into typical form. Patients initially presenting with motor phenotype and subsequent NP more often progressed to typical CIDP. Serum paraprotein was more frequently detected in patients with NP (47.0% vs. 26.9% in those without NP). Positive antinuclear factor (ANF) titer (ANF ≥320) in NP patients was significantly associated with rheumatologic diseases.

CONCLUSION

Clinical and laboratory characteristics in patients with neuropathic pain should be considered when selecting optimal therapy.