Treatment-resistant CIDP in an IgG Tubulin Autoantibody Positive Patient: case report and review of the literature

Objectives:  To describe a case of rapidly relapsing chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in the setting of positive serum IgG tubulin autoantibodies. Methods: We wrote a case report and performed a literature review of IgG tubulin autoantibodies and the use of rituximab in treatment resistant CIDP. Results: Our case report describes a 29-year-old woman with CIDP that was resistant to treatment with steroids, intravenous immunoglobulin, and plasma exchange. An extensive workup of her rapidly relapsing CIDP was negative, with the exception of positive serum IgG tubulin autoantibodies. She ultimately stabilized on oral steroids, plasma exchange and rituximab, with a regular recurrence of weakness occurring approximately every month that led to rehospitalization. Conclusion: Anti-tubulin antibodies could be a marker of a subtype of CIDP that is treatment resistant. We detail her clinical course to serve as an example for other cases of IgG tubulin autoantibody positive CIDP patients that could be described in the future