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Neurology (Expert Forum)
Re: Cyclophosphamide used for treatment of sensory Neuropathy?
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Re: Cyclophosphamide used for treatment of sensory Neuropathy?
by CCF Neurology MD:NT, Jan 01, 1995 12:00AM
Posted By CCF Neurology MD:NT on October 29, 1998 at 19:00:12:
In Reply to: Cyclophosphamide used for treatment of sensory Neuropathy? posted by Bill Green on October 28, 1998 at 19:37:54:
DEAR CCF,
I HOPE YOU CAN EXPLAIN ABOUT THIS>
MY PHYSICIAN TELLS ME A ANTIBODY TEST SHOWED THAT I DID NOT HAVE A SYSTEMIC AUTOIMMUNE RESPONSE BUT ONLY ONE AFFECTING MY SENSORY NERVES> HE SUGGESTED THE USE
OF CYCLOPHOSPHAMIDE? FROM WHAT I READ THIS SOUNDS MORE DANGEROUS THEN THE SENSORY PAIN I HAVE?
CAN'T THIS TYPE OF SPECIFIC AUTOIMMUNE RESPONSE HAPPENING TO THE NERVES ONLY JUST SUBSIDE ON ITS OWN>
PLEASE LET ME KNOW! I AM EXTREMELY RELUCTANT TO TAKE THAT MEDICATION GIVEN WHAT I HAVE READ ABOUT IT> AND DO NOT KNOW HOW APPROPRIATE IT IS TO TREAT MY CONDITION>
Dear Bill:
I share your concerns.
Some specific antibodies (anti- MAG, sulfatide, and SGPG) have been found to be associated with some patterns of sensory neuropathy. Some of these neuropathies can be quite disabling from severe sensory impairment, loss of coordination, and pain, while others are quite mild. The neuropathies may or may not be progressive. Some other forms of immune neuropathies (vasculitic, cryoglobulinemic, paraproteinemic, GBS/CIDP) may be predominantly sensory also, and some of them have associated blood tests that are abnormal.
The use of cyclophosphamide is generally reserved for some of the immune mediated neuropathies that are disabling from motor dysfunction or profound sensory loss, or are anticipated to be progessive. vasculitic neuropathies are a definite indication for the use of cyclophosphamide.
I agree that cyclophosphamide is a toxic drug with very serious potential short-term and long-term adverse effects (including leukemia). I would be reluctant to use the drug for non-progressive sensory signs/symptoms, or pain alone.
You are welcome for a second opinion from the neuromuscular section at the Cleveland Clinic. Appointments can be made by calling (800)223-2273, or (216)444-5559.
In Reply to: Cyclophosphamide used for treatment of sensory Neuropathy? posted by Bill Green on October 28, 1998 at 19:37:54:
DEAR CCF,
I HOPE YOU CAN EXPLAIN ABOUT THIS>
MY PHYSICIAN TELLS ME A ANTIBODY TEST SHOWED THAT I DID NOT HAVE A SYSTEMIC AUTOIMMUNE RESPONSE BUT ONLY ONE AFFECTING MY SENSORY NERVES> HE SUGGESTED THE USE
OF CYCLOPHOSPHAMIDE? FROM WHAT I READ THIS SOUNDS MORE DANGEROUS THEN THE SENSORY PAIN I HAVE?
CAN'T THIS TYPE OF SPECIFIC AUTOIMMUNE RESPONSE HAPPENING TO THE NERVES ONLY JUST SUBSIDE ON ITS OWN>
PLEASE LET ME KNOW! I AM EXTREMELY RELUCTANT TO TAKE THAT MEDICATION GIVEN WHAT I HAVE READ ABOUT IT> AND DO NOT KNOW HOW APPROPRIATE IT IS TO TREAT MY CONDITION>
Dear Bill:
I share your concerns.
Some specific antibodies (anti- MAG, sulfatide, and SGPG) have been found to be associated with some patterns of sensory neuropathy. Some of these neuropathies can be quite disabling from severe sensory impairment, loss of coordination, and pain, while others are quite mild. The neuropathies may or may not be progressive. Some other forms of immune neuropathies (vasculitic, cryoglobulinemic, paraproteinemic, GBS/CIDP) may be predominantly sensory also, and some of them have associated blood tests that are abnormal.
The use of cyclophosphamide is generally reserved for some of the immune mediated neuropathies that are disabling from motor dysfunction or profound sensory loss, or are anticipated to be progessive. vasculitic neuropathies are a definite indication for the use of cyclophosphamide.
I agree that cyclophosphamide is a toxic drug with very serious potential short-term and long-term adverse effects (including leukemia). I would be reluctant to use the drug for non-progressive sensory signs/symptoms, or pain alone.
You are welcome for a second opinion from the neuromuscular section at the Cleveland Clinic. Appointments can be made by calling (800)223-2273, or (216)444-5559.
