Chronic inflammatory demyelinating polyradiculoneuropathy in chronic graft-versus-host disease following allogeneic hematopoietic stem cell transplantation: case report

Lorenzoni, Paulo José; Scola, Rosana Hermínia; Moreira, Ana Lucila; Trentin, Ana Paula; Teive, Hélio A.G.; Pasqüini, Ricardo; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2007000400031

Cited by 26 publications

(17 citation statements)

References 20 publications

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“…More recently, a case of a patient with chronic inflammatory demyelinating polyradiculoneuropathy in chronic graft-versus-host disease following allogeneic hematopoietic stem cell transplantation was reported 30 .…”

Section: Discussionmentioning

confidence: 99%

Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil

Teive

Funke

Bitencourt

et al. 2008

Arq. Neuro-Psiquiatr.

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-We present the neurological complications evaluated in a series of 1000 patients who underwent hematopoietic stem cell transplantation (hsct). central nervous system (cNs) neurological complications, particularly brain hemorrhages, were the most common, followed by seizures and cNs infections. An unusual neurological complication was Wernicke's encephalopathy. Less frequent neurological complications were metabolic encephalopathy, neuroleptic malignant syndrome, reversible posterior leukoencephalopathy syndrome, brain infarct and movement disorders. the most common neurological complication of the peripheral nervous system was herpes zoster radiculopathy, while peripheral neuropathies, inflammatory myopathy and myotonia were very rarely found.KEY WORDs: neurological complications, hematopoietic stem cell transplantation, stem-cell transplantation. Complicações neurológicas do transplante de células tronco hematopoiéticas (TCTH): estudo retrospectivo em um centro de TCTH no BrasilResumo -Apresentamos as complicações neurológicas avaliadas em uma série de 1000 pacientes submetidos ao transplante de células tronco hematopoiéticas (tcth). As complicações neurológicas do sistema nervoso central foram as mais encontradas, particularmente as hemorragias encefálicas, seguidas por crises convulsivas e por infecções. Uma complicação peculiar foi a encefalopatia de Wernicke. Menos freqüentemente foram encontrados casos de encefalopatia metabólica, síndrome maligna neuroléptica, leucoencefalopatia posterior reversível, infarto cerebral e os distúrbios do movimento. Entre as complicações neurológicas do sistema nervoso periférico a mais encontrada foi a radiculopatia pelo herpes zoster, enquanto que raramente se observaram casos de polineuropatias periféricas, miopatia inflamatória e de miotonia.PALAvRAs-chAvE: complicações neurológicas, transplante de células tronco hematopoiéticas, transplante de precursores hematopoiéticos.

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Section: Discussionmentioning

confidence: 99%

Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil

Teive

Funke

Bitencourt

et al. 2008

Arq. Neuro-Psiquiatr.

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“…Graft versus host disease (GVHD) represents one of the most important complications of hematopoietic stem cells transplantation (HSCT), encompassing both an acute form characterized by cutaneous and enteral manifestations (Filipovich et al ., ) and a chronic form associated to a wide series of complications (Filipovich et al ., ; Filipovich, ; Jagasia et al ., ) . In addition, several neuro‐immunological disorders have been also reported with GVHD including cases of myasthenia gravis (Smith et al ., ; Bolger et al ., ) , polymyositis (Anderson et al ., ; Couriel et al ., ) , encephalopathies (Rouah et al ., ; Iwasaki et al ., ; Bossi et al ., ) , plexopathies, (Karam et al ., ) and chronic polyneuropathies, many showing a clinical and neurophysiological phenotype similar to chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) (Amato et al ., ; Griggs et al ., ; Nagashima et al ., ; Peters and Larner , ; Lorenzoni et al ., ; Suzuki et al ., ; Wada et al ., ) .…”

Section: Introductionmentioning

confidence: 97%

CIDP‐like neuropathies in graft versus host disease

Cocito

Romagnolo

Rosso

et al. 2015

J Peripheral Nervous Sys

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Cases of chronic inflammatory demyelinating poliradiculoneuropathy (CIDP) have been reported in hematopoietic stem cells transplantation complicated by graft versus host disease (GVHD). A systematic review of the CIDP-like neuropathies associated with GVHD was conducted until January 2015, analyzing the clinical presentation and the response to different therapeutic regimens. Nineteen patients have been reported in literature including the present one. Fourteen subjects fulfilled the criteria for CIDP, whereas two cases presented with an asymmetric motor onset and one showed motor involvement only associated with anti-ganglioside antibodies. In addition, two subjects already affected by CIDP developed a significant relapse after GVHD. This study reviews the literature data and reports one additional case of CIDP and GVHD, suggesting that the two clinical entities might share a similar immunological background.

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“…The clinical and electrophysiological presentation of GVHD-associated acute and chronic neuropathies is heterogeneous and resembles features of Guillain-Barré syndrome (GBS) [10], [11], chronic inflammatory demyelinating polyneuropathy (CIDP) [12], [13], or chronic immune-mediated axonal polyneuropathy [14]. Usually, the diagnostic criteria of GBS or CIDP are not met completely [15], [16], [17].…”

Section: Introductionmentioning

confidence: 99%

Muscle Cramps and Neuropathies in Patients with Allogeneic Hematopoietic Stem Cell Transplantation and Graft-versus-Host Disease

et al. 2012

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ObjectiveGraft-versus-host disease (GVHD) is an immune-mediated multisystemic disorder and the leading cause of morbidity after allogeneic hematopoietic stem cell transplantation. Peripheral nervous system manifestations of GVHD are rare but often disabling. Whereas immune-mediated neuropathies are an established feature of GVHD, muscle cramps are not well characterized.MethodsIn a single-centre retrospective cohort we studied 27 patients (age 23 to 69 years) with GVHD (acute n = 6, chronic n = 21) who complained of symptoms suggestive of peripheral nervous system complications. Clinical, laboratory and neurophysiological findings were evaluated by descriptive statistics and regression analysis to detect factors associated with muscle cramps. Patient’s sera were examined for anti-neuronal antibodies.ResultsNine patients had polyneuropathy, 4 had muscle cramps, and 14 had both. Median onset of polyneuropathy and muscle cramps was 6 and 9 months after allogeneic hematopoietic stem cell transplantation, respectively. Neurophysiology revealed a predominantly axonal polyneuropathy in 20 of 26 patients. In 4 of 19 patients electromyography showed signs of myopathy or myositis. Muscle cramps were more frequent during chronic than acute GVHD and affected muscles other than calves in 15 of 18 patients. They typically occurred daily, lasted 1 to 10 minutes with medium to severe pain intensity, compromised daily activity or sleep in 12, and were refractory to therapy in 4 patients. Muscle cramps were less likely with tacrolimus treatment and signs of severe polyneuropathy, but more likely with myopathic changes in electromyography and with incipient demyelinating polyneuropathy, shown by increased high frequency attenuation of the tibial nerve. Serological studies revealed antinuclear or antimitochondrial antibodies in a subset of patients. Two of 16 patients had a serum reactivity against peripheral nervous tissue.ConclusionMuscle cramps are associated with chronic GVHD, often compromise daily activity, and correlate negatively with axonal polyneuropathy and positively with myopathy and incipient demyelination.

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Chronic inflammatory demyelinating polyradiculoneuropathy in chronic graft-versus-host disease following allogeneic hematopoietic stem cell transplantation: case report

Cited by 26 publications

References 20 publications

Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil

Neurological complications of hematopoietic stem cell transplantation (HSCT): a retrospective study in a HSCT center in Brazil

CIDP‐like neuropathies in graft versus host disease

Muscle Cramps and Neuropathies in Patients with Allogeneic Hematopoietic Stem Cell Transplantation and Graft-versus-Host Disease

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