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Abstract
Autoimmune neuropathy may present acutely or with a more progressive and/or relapsing and remitting course. Acute inflammatory neuropathy or Guillain-Barré syndrome (GBS) has variable presentations but by far the most common is acute inflammatory demyelinating polyradiculoneuropathy which is characterized by rapidly progressive proximal and distal symmetric weakness, sensory loss, and depressed reflexes. The most common chronic autoimmune neuropathy is chronic inflammatory demyelinating polyradiculoneuropathy, which in its most typical form is clinically similar to acute inflammatory demyelinating polyradiculoneuropathy (proximal and distal symmetric weakness, sensory loss, and depressed reflexes) but differs in that onset is much more gradual, i.e., over at least 8 weeks. While the majority of GBS cases result from a postinfectious activation of the immune system, presumably in a genetically susceptible host, less is understood regarding the etiopathogenesis of chronic inflammatory demyelinating polyradiculoneuropathy. Both acute and chronic forms of these inflammatory neuropathies are driven by some combination of innate and adaptive immune pathways, with differing contributions depending on the neuropathy subtype. Both disorders are largely clinical diagnoses, but diagnostic tools are available to confirm the diagnosis, prognosticate, detect variant forms, and rule out mimics. Given the autoimmune underpinnings of both disorders, immunosuppressive and immunomodulating treatments are typically given in both diseases; however, they differ in their response to treatment.
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Affiliation(s)
- Caroline Miranda
- Department of Neurology, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, United States.
| | - Thomas H Brannagan
- Department of Neurology, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, United States
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Malik A, Berry R, Fung BM, Tabibian JH. Association between chronic inflammatory demyelinating polyneuropathy and gastrointestinal malignancies. Clin J Gastroenterol 2020; 14:1-13. [PMID: 33146871 DOI: 10.1007/s12328-020-01281-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022]
Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an uncommon and under-recognized immune-mediated disorder of the peripheral nervous system. It is associated with both infectious and non-infectious etiologies and presents in several variant forms. In rare instances, CIDP has been reported in association with gastrointestinal (esophageal, hepatic, colorectal, and pancreatic) malignancies. The diagnosis of malignancy is typically preceded by weeks to months by that of CIDP, though the inverse may also be seen. As with other etiologies of CIDP, cases associated with gastrointestinal malignancies are often treated with corticosteroids, intravenous immunoglobulins, and/or plasma exchange, with improvement or resolution of neurological symptoms in the majority of cases. In this review, we provide a practical overview of CIDP, with an emphasis on recognizing the clinical association between CIDP and gastrointestinal malignancies.
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Affiliation(s)
- Adnan Malik
- Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA
| | - Rani Berry
- Department of Internal Medicine, UCLA Ronald Reagan Medical Center, Los Angeles, CA, USA
| | - Brian M Fung
- Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA
| | - James H Tabibian
- Division of Gastroenterology, Olive View-UCLA Medical Center, 14445 Olive View Dr, Sylmar, CA, 2B-182, USA. .,David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Ceccanti M, Pozzilli V, Cambieri C, Libonati L, Onesti E, Frasca V, Fiorini I, Petrucci A, Garibaldi M, Palma E, Bendotti C, Fabbrizio P, Trolese MC, Nardo G, Inghilleri M. Creatine Kinase and Progression Rate in Amyotrophic Lateral Sclerosis. Cells 2020; 9:cells9051174. [PMID: 32397320 PMCID: PMC7291088 DOI: 10.3390/cells9051174] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 11/16/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with no recognized clinical prognostic factor. Creatinine kinase (CK) increase in these patients is already described with conflicting results on prognosis and survival. In 126 ALS patients who were fast or slow disease progressors, CK levels were assayed for 16 months every 4 months in an observational case-control cohort study with prospective data collection conducted in Italy. CK was also measured at baseline in 88 CIDP patients with secondary axonal damage and in two mouse strains (129SvHSD and C57-BL) carrying the same SOD1G93A transgene expression but showing a fast (129Sv-SOD1G93A) and slow (C57-SOD1G93A) ALS progression rate. Higher CK was found in ALS slow progressors compared to fast progressors in T1, T2, T3, and T4, with a correlation with Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) scores. Higher CK was found in spinal compared to bulbar-onset patients. Transgenic and non-transgenic C57BL mice showed higher CK levels compared to 129SvHSD strain. At baseline mean CK was higher in ALS compared to CIDP. CK can predict the disease progression, with slow progressors associated with higher levels and fast progressors to lower levels, in both ALS patients and mice. CK is higher in ALS patients compared to patients with CIDP with secondary axonal damage; the higher levels of CK in slow progressors patients, but also in C57BL transgenic and non-transgenic mice designs CK as a predisposing factor for disease rate progression.
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Affiliation(s)
- Marco Ceccanti
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Valeria Pozzilli
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Chiara Cambieri
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Laura Libonati
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Emanuela Onesti
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Vittorio Frasca
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Ilenia Fiorini
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
| | - Antonio Petrucci
- Centre for Neuromuscular and Neurological Rare Diseases, San Camillo Forlanini Hospital, 00152 Rome, Italy;
| | - Matteo Garibaldi
- Neuromuscular Disease Centre, Department of Neurology, Mental Health and Sensory Organs (NESMOS), Sant’Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Eleonora Palma
- Department of Physiology and Pharmacology, Laboratory Affiliated to Istituto Pasteur Italia, Sapienza University of Rome, 00185 Rome, Italy;
| | - Caterina Bendotti
- Laboratory Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Famacologiche Mario Negri-IRCCS, 20156 Milan, Italy; (C.B.); (P.F.); (M.C.T.); (G.N.)
| | - Paola Fabbrizio
- Laboratory Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Famacologiche Mario Negri-IRCCS, 20156 Milan, Italy; (C.B.); (P.F.); (M.C.T.); (G.N.)
| | - Maria Chiara Trolese
- Laboratory Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Famacologiche Mario Negri-IRCCS, 20156 Milan, Italy; (C.B.); (P.F.); (M.C.T.); (G.N.)
| | - Giovanni Nardo
- Laboratory Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Famacologiche Mario Negri-IRCCS, 20156 Milan, Italy; (C.B.); (P.F.); (M.C.T.); (G.N.)
| | - Maurizio Inghilleri
- Rare Neuromuscular Diseases Centre, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (M.C.); (V.P.); (C.C.); (L.L.); (E.O.); (V.F.); (I.F.)
- Correspondence: ; Tel.: +39-0-6499-14122
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Sural nerve biopsy in peripheral neuropathies: 30-year experience from a single center. Neurol Sci 2019; 41:341-346. [DOI: 10.1007/s10072-019-04082-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/18/2019] [Indexed: 12/15/2022]
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Koike H, Nishi R, Ikeda S, Kawagashira Y, Iijima M, Atsuta N, Nakamura T, Hirayama M, Ogata H, Yamasaki R, Kira JI, Katsuno M, Sobue G. Restoration of a Conduction Block after the Long-term Treatment of CIDP with Anti-neurofascin 155 Antibodies: Follow-up of a Case over 23 Years. Intern Med 2018; 57:2061-2066. [PMID: 29491293 PMCID: PMC6096034 DOI: 10.2169/internalmedicine.0455-17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a woman with chronic inflammatory demyelinating polyneuropathy (CIDP) in whom positivity for anti-neurofascin 155 antibodies was revealed 23 years after the onset of neuropathy. The patient initially reported numbness in the face at 50 years of age and subsequently manifested features compatible to typical CIDP. Steroid administration initiated at 54 years of age ameliorated her neuropathic symptoms. Although the nerve conduction indices at 59 years of age deteriorated, those at 68, 72, and 73 years of age showed a gradual recovery. The deterioration and subsequent restoration of compound muscle action potential amplitudes was the most dramatic, suggesting that a conduction block can be reversed earlier than other electrophysiological indices.
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Affiliation(s)
- Haruki Koike
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Ryoji Nishi
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Shohei Ikeda
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Yuichi Kawagashira
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Masahiro Iijima
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Naoki Atsuta
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Tomohiko Nakamura
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Masaaki Hirayama
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Hidenori Ogata
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Ryo Yamasaki
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Jun-Ichi Kira
- Department of Neurology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
| | - Gen Sobue
- Department of Neurology, Nagoya University Graduate School of Medicine, Japan
- Research Division of Dementia and Neurodegenerative Disease, Nagoya University Graduate School of Medicine, Japan
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Cao D, Guo X, Yuan T, Hao J. Diagnosing chronic inflammatory demyelinating polyradiculoneuropathy with triple stimulation technique. J Neurol 2018; 265:1916-1921. [PMID: 29926221 DOI: 10.1007/s00415-018-8929-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the value of triple stimulation technique (TST) for diagnose of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). METHODS Seven clinically suspected CIDP patients who did not fulfill EFNS/PNS electrodiagnostic criteria for demyelinating neuropathy were enrolled in our study. Routine nerve conduction studies, lumbar puncture, spinal cord magnetic resonance imaging and TST were detected. The patients were being treated with oral prednisone starting at 1 mg/kg daily. The overall disability sum score was performed to evaluate the effect of corticosteroids. RESULTS Twenty-eight motor nerves were tested with TST, two conduction blocks (CBs) were detected between the root emergence and the Erb point in six patients respectively and one CB was detected in one patient. Symptoms of all seven patients improved after treatment with oral prednisone. CONCLUSION TST can detect CBs located between the root emergence and the Erb point. TST is useful for early diagnosis of CIDP.
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Affiliation(s)
- Du Cao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China
| | - Xiuming Guo
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Friendship Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
| | - Ting Yuan
- Department of Neurology, 363 Hospital, Chengdu, China
| | - Jie Hao
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Illes Z, Blaabjerg M. Cerebrospinal fluid findings in Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathies. HANDBOOK OF CLINICAL NEUROLOGY 2017; 146:125-138. [PMID: 29110767 DOI: 10.1016/b978-0-12-804279-3.00009-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The classic immunologic alteration of the cerebrospinal fluid (CSF) in Guillain-Barré syndrome (GBS), albuminocytologic dissociation, has been known since the original paper by Guillain, Barré, and Strohl. Albuminocytologic dissociation has been also described in other forms of the GBS spectrum, such as axonal motor or motor-sensory forms (AMAN, AMSAN), the anti-GQ1b spectrum of Miller Fisher syndrome, and Bickerstaff brainstem encephalitis. Cytokines, chemokines, antibodies, complement components, and molecules with a putative neuroprotective role or indicating axonal damage have also been examined using different methods. Besides these candidate approaches, proteomics has been recently applied to discover potential biomarkers. The overall results support the immunopathogenesis of GBS, but albuminocytologic dissociation remained the only consistent CSF biomarker supporting the diagnosis of GBS. Chronic inflammatory neuropathies also comprise a heterogeneous group of diseases. Increased protein in the CSF is a supportive factor of chronic inflammatory demyelinating polyneuropathy, especially in the absence of definite electrophysiologic criteria. A number of other markers have also been investigated in the CSF of patients with chronic inflammatory neuropathies, similar to GBS. However, none has been used in supporting diagnosis, differentiating among syndromes, or predicting the clinical course and treatment responses.
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Affiliation(s)
- Zsolt Illes
- Department of Neurology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Morten Blaabjerg
- Department of Neurology, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Cao Y, Menon P, Ching-Fen Chang F, Mahant N, Geevasinga N, Fung VSC, Vucic S. Postural tremor and chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2016; 55:338-343. [PMID: 27421831 DOI: 10.1002/mus.25253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/27/2016] [Accepted: 07/12/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Chronic inflammatory demyelinating polyneuropathy (CIDP) typically presents with a combination of sensory and motor impairments. Tremor is recognized as a common and debilitating feature in CIDP, although the underlying mechanisms are unclear. METHODS Clinical tremor severity and disability scores were collected prospectively in 25 CIDP patients and compared with 22 neuromuscular controls. RESULTS Postural and kinetic tremor were significantly more frequent in CIDP patients (80%) than in neuromuscular controls (35%; P < 0.005). Tremor severity and tremor-related disability were also significantly greater in CIDP patients than in controls. Accelerometry data confirmed the presence of a 5.5 Hz postural tremor and a 5 Hz kinetic tremor. CONCLUSIONS Tremor appears to be a common clinical feature of CIDP that results in significant disability. Sensory and motor impairment may be associated with development of tremor in CIDP. Muscle Nerve 55: 338-343, 2017.
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Affiliation(s)
- Yiming Cao
- Western Clinical School, University of Sydney, Sydney, Australia
| | - Parvathi Menon
- Western Clinical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, Cnr Hawkesbury and Darcy Road, Westmead, NSW, 2145
| | - Florence Ching-Fen Chang
- Western Clinical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, Cnr Hawkesbury and Darcy Road, Westmead, NSW, 2145
| | - Neil Mahant
- Western Clinical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, Cnr Hawkesbury and Darcy Road, Westmead, NSW, 2145
| | | | - Victor S C Fung
- Western Clinical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, Cnr Hawkesbury and Darcy Road, Westmead, NSW, 2145
| | - Steve Vucic
- Western Clinical School, University of Sydney, Sydney, Australia.,Department of Neurology, Westmead Hospital, Cnr Hawkesbury and Darcy Road, Westmead, NSW, 2145.,Westmead Millennium Institute, Sydney, Australia
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Merkies ISJ, Kieseier BC. Fatigue, Pain, Anxiety and Depression in Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy. Eur Neurol 2016; 75:199-206. [PMID: 27077919 DOI: 10.1159/000445347] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/08/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the clinical evaluation of patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), scant attention is paid to symptoms such as fatigue, pain and anxiety/depression. We aimed at addressing seminal studies that focused on the burden of these symptoms and their impact on quality of life (QoL) in these conditions. SUMMARY Fatigue, pain, and anxiety/depression are increasingly being recognized in patients with GBS and CIDP, although their pathophysiological provenance remains unknown. Fatigue and pain are significant in terms of prevalence and intensity, may be a presenting symptom, and can persist for years after apparent functional recovery, suggesting residual injury. Anxiety/depression has also been examined although studies are limited. Despite their negative impact on QoL, the long-term dynamics of these symptoms in patients with GBS and particularly CIDP receiving therapy in routine clinical practice have not been systematically evaluated. Such observations formed the basis for the ongoing (GAMEDIS) studies evaluating the effect of Gamunex on fatigue and depression in patients with CIDP, of which some preliminary data are presented. KEY MESSAGES Strength and sensory deficits are the main areas of focus in patients with GBS and CIDP, but they do not explain the total reduction in QoL, suggesting the possible role of other complaints. A more comprehensive approach to patient care demands that factors such as pain, fatigue and anxiety/depression receive greater attention. The non-interventional GAMEDIS studies are expected to provide valuable insight into the long-term effectiveness of Gamunex in everyday practice.
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Affiliation(s)
- Ingemar S J Merkies
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Mathey EK, Park SB, Hughes RAC, Pollard JD, Armati PJ, Barnett MH, Taylor BV, Dyck PJB, Kiernan MC, Lin CSY. Chronic inflammatory demyelinating polyradiculoneuropathy: from pathology to phenotype. J Neurol Neurosurg Psychiatry 2015; 86:973-85. [PMID: 25677463 PMCID: PMC4552934 DOI: 10.1136/jnnp-2014-309697] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 11/04/2022]
Abstract
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an inflammatory neuropathy, classically characterised by a slowly progressive onset and symmetrical, sensorimotor involvement. However, there are many phenotypic variants, suggesting that CIDP may not be a discrete disease entity but rather a spectrum of related conditions. While the abiding theory of CIDP pathogenesis is that cell-mediated and humoral mechanisms act together in an aberrant immune response to cause damage to peripheral nerves, the relative contributions of T cell and autoantibody responses remain largely undefined. In animal models of spontaneous inflammatory neuropathy, T cell responses to defined myelin antigens are responsible. In other human inflammatory neuropathies, there is evidence of antibody responses to Schwann cell, compact myelin or nodal antigens. In this review, the roles of the cellular and humoral immune systems in the pathogenesis of CIDP will be discussed. In time, it is anticipated that delineation of clinical phenotypes and the underlying disease mechanisms might help guide diagnostic and individualised treatment strategies for CIDP.
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Affiliation(s)
- Emily K Mathey
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Susanna B Park
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia Neuroscience Research Australia & Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales, Australia
| | - Richard A C Hughes
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - John D Pollard
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Patricia J Armati
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Michael H Barnett
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Bruce V Taylor
- Menzies Research Institute, University of Tasmania, Sydney, New South Wales, Australia
| | - P James B Dyck
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew C Kiernan
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Cindy S-Y Lin
- Faculty of Medicine, Department of Physiology, Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, Randwick, New South Wales, Australia
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Gasparotti R, Lucchetta M, Cacciavillani M, Neri W, Guidi C, Cavallaro T, Ferrari S, Padua L, Briani C. Neuroimaging in diagnosis of atypical polyradiculoneuropathies: report of three cases and review of the literature. J Neurol 2015; 262:1714-23. [PMID: 25957643 DOI: 10.1007/s00415-015-7770-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 01/20/2023]
Abstract
Neuroimaging is increasingly used in the study of peripheral nerve diseases, and sometimes may have a pivotal role in the diagnostic process. We report on three patients with atypical chronic inflammatory polyradiculoneuropathy (CIDP) in whom magnetic resonance imaging (MRI) and nerve Ultrasound (US) were crucial for a correct diagnostic work-out. A literature review on MRI and US in acquired demyelinating polyneuropathies is also provided. Awareness of the imaging features of CIDP will assist in confirmation of the diagnosis, institution of the appropriate therapy, and prevention of inadequate or delayed treatment in atypical CIDP.
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Affiliation(s)
- Roberto Gasparotti
- Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy,
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Alsunousi S, Marrif HI. Diabetic neuropathy and the sensory apparatus "meissner corpuscle and merkel cells". Front Neuroanat 2014; 8:79. [PMID: 25177276 PMCID: PMC4132297 DOI: 10.3389/fnana.2014.00079] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/22/2014] [Indexed: 01/30/2023] Open
Affiliation(s)
- Salma Alsunousi
- Department of Histology, Faculty of Medicine, Benghazi University Benghazi, Libya
| | - Husnia I Marrif
- Department of Pharmaceutical Sciences, Princess Noura University Riyadh, Saudi Arabia
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