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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(07): s00451809884
DOI: 10.1055/s-0045-1809884
Brazilian Academy of Neurology

Brazilian Academy of Neurology recommendations for diagnosis, management, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)

Osvaldo J. M. Nascimento 
1   Universidade Federal Fluminense, Faculdade de Medicina, Niterói RJ, Brazil.
,
Wilson Marques Jr 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Marcus Vinícius Magno Gonçalves 
3   Universidade de Joinville, Joinville SC, Brazil.
,
Pedro José Tomaselli 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Camila Pupe 
1   Universidade Federal Fluminense, Faculdade de Medicina, Niterói RJ, Brazil.
,
Marcondes Cavalcante França Jr 
4   Universidade de Campinas, Faculdade de Ciências Médicas, Campinas SP, Brazil.
,
Francisco de Assis Aquino Gondim 
5   Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza CE, Brazil.
,
Marcos Raimundo Gomes de Freitas 
1   Universidade Federal Fluminense, Faculdade de Medicina, Niterói RJ, Brazil.
,
Rodrigo Siqueira Soares Frezatti 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Acary Souza Bulle Oliveira 
6   Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo SP, Brazil.
,
Francisco Tellechea Rotta 
7   Hospital Moinhos de Vento, Porto Alegre RS, Brazil.
8   Santa Casa de Misericórdia de Porto Alegre, Porto Alegre RS, Brazil.
,
Elza Dias Tosta 
9   Hospital dos Servidores da União de Brasília, Brasília DF, Brazil.
,
Rosana Scola 
10   Universidade Federal do Paraná, Curitiba PR, Brazil.
,
Vanessa Daccach 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Carlo Domenico Marrone 
11   Clinica Marrone, Porto Alegre, RS, Brazil.
,
Jefferson Becker 
12   Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Medicina, Instituto do Cérebro, Porto Alegre RS, Brazil.
,
Susanie Rigatto 
13   Hospital Geral de Goiânia, Goiânia GO, Brazil.
,
Alberto R. M. Martinez 
4   Universidade de Campinas, Faculdade de Ciências Médicas, Campinas SP, Brazil.
,
Hideraldo Cabeça 
14   Hospital Geral de Belém, Belém PA, Brazil.
,
Pablo Brea Winckler 
15   Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre RS, Brazil.
,
Mario Emilio Dourado 
16   Universidade Federal do Rio Grande do Norte, Faculdade de Medicina, Natal RN, Brazil.
,
Diogo Fernandes dos Santos 
17   Universidade Federal de Uberlândia, Faculdade de Medicina, Uberlândia MG, Brazil.
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Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune disorder that leads to progressive motor and sensory impairment, resulting in significant morbidity. While the incidence rates vary, CIDP remains a challenging condition requiring a standardized and optimized approach to diagnosis and management. In Brazil, a middle-income country with substantial regional disparities in healthcare access, the availability of specialized neuromuscular centers is uneven, creating obstacles to timely and effective treatment. To address these challenges, the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, ABN, in Portuguese) has developed national recommendations for the diagnosis, management, and treatment of CIDP, tailored to the country's healthcare resources. This consensus outlines standardized diagnostic criteria that incorporate electrophysiological and imaging findings, and it emphasizes key differential diagnoses to enhance diagnostic accuracy. The recommendations were developed through expert panel discussions and a non-systematic review of the literature. The recommended treatment strategies include first-line therapies such as corticosteroids, intravenous immunoglobulin (IVIg), and plasmapheresis, with guidance on escalation and titration of immunosuppressive therapy in refractory cases. By emphasizing early intervention to prevent axonal degeneration and disability, these guidelines aim to improve clinical outcomes and support public health policies within the Brazilian National Health System (Sistema Único de Saúde, SUS, in Portuguese), ensuring equitable and effective CIDP management across the country.

Keywords

Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - Consensus - Diagnosis - Therapeutics

Authors' Contributions

Conceptualization: OJMN, WMJ, MVMG, PT, CP, FAAQ, RSSF, FTR, EDT, VSM; Data curation: OJMN; Investigation: OJMN, WMJ, MVMG, PT, CP, MCFJ, MRGF, RSSF, ASBO, VSM, CDM; Methodology: OJMN, WMJ, MVMG, PT, MCFJ, FAAQ, MRGF, RSSF, ASBO, FTR, EDT, RHS, CDM, JB, DS; Project administration: OJMN; Resources: OJMN, WMJ, MVG, PT, CP, MCFJ, FAAQ, RSSF, ASBO, FTR, EDT, RHS, VSM, MED; Supervision: OJMN, MED, DS; Validation: RSSF; Visualization: PT, FTR, RHS; Writing – original draft: OJMN, WMJ, MVMG, FAAQ, MRGF, RSSF, EDT, VSM, CDM, JB, SR, ARMM, HC, PBW, MED, DS; Writing – review & editing: OJMN, WMJ, MVG, PT, CP, MCFJ, FAAQ, MRGF, RSSF, ASBO, FTR, EDT, RHS, VSM, CDM, JB, SR, ARMM, HC, PBW, MED, DS.


Data Availability Statement

The contents underlying the research text are included in the manuscript.


Editor-in-Chief: Hélio A. G. Teive 0000-0003-2305-1073.


Associate Editor: Edmar Zanotelli 0000-0002-4991-6760.




Publication History

Received: 28 February 2025

Accepted: 26 April 2025

Article published online:
28 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Osvaldo J. M. Nascimento, Wilson Marques Jr, Marcus Vinícius Magno Gonçalves, Pedro José Tomaselli, Camila Pupe, Marcondes Cavalcante França Jr, Francisco de Assis Aquino Gondim, Marcos Raimundo Gomes de Freitas, Rodrigo Siqueira Soares Frezatti, Acary Souza Bulle Oliveira, Francisco Tellechea Rotta, Elza Dias Tosta, Rosana Scola, Vanessa Daccach, Carlo Domenico Marrone, Jefferson Becker, Susanie Rigatto, Alberto R. M. Martinez, Hideraldo Cabeça, Pablo Brea Winckler, Mario Emilio Dourado, Diogo Fernandes dos Santos. Brazilian Academy of Neurology recommendations for diagnosis, management, and treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Arq Neuropsiquiatr 2025; 83: s00451809884.
DOI: 10.1055/s-0045-1809884