Subcutaneous immunoglobulin therapy for the treatment of multifocal motor neuropathy: a case report

Multifocal motor neuropathy (MMN) is a rare immune-mediated disease characterized by slowly progressive, asymmetric, predominantly distal weakness of one or more limbs without sensory loss. The first line of treatment is high-dose intravenous immunoglobulins (IVIg). Subcutaneous immunoglobulins (SCIg)already approved for the treatment of primary immune deficiency have recently been proposed also for the treatment of disimmune peripheral neuropathies such as MMN, and a few trials were performed to see if patients receiving immunomodulatory doses of IVIg could be treated equally well with SCIg. We describe a patient affected by MMN who was included in a protocol of treatment with SCIg for a period of 6 months. He successfully responded to treatment with a stabilization of strength. The patient is still treated with SCIg even after the end of the protocol. This is the first description of an Italian case of a patient affected by MMN successfully treated with SCIg.