Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy

Bouchard, Charles S.; Lacroix, Catherine; Planté, Violaine; Adams, David H.; Chédru, F; Guglielmi, Jean-Marc; Saïd, Gérard

doi:10.1212/wnl.52.3.498

Cited by 275 publications

(203 citation statements)

References 33 publications

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“…9 The sural nerve which is commonly biopsied is a distal sensory nerve which is not usually affected in the pathologic process. 10,11 The brunt of nerve dysfunction falls on the motor fibres, nerve roots and proximal trunk. The extent of autonomic nervous involvement could not be ascertained as we lack diagnostic facilities to do so.…”

Section: Discussionmentioning

confidence: 99%

Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

Iyagba

Chioma

2017

Int J Adv Med

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A 31 year old female presented with a one-year history of burning sensations, numbness and tingling feelings in her hands and feet. There was also excessive sweatiness of her hands and feet while experiencing these symptoms. Her symptoms were worse at night and during hot weather conditions and aggravated by contact with light clothing. She could not tolerate her shoes. She also complained of weakness in her distal lower limbs. Examination revealed prominent wasting of the thenar and hypothenar eminences, marked bilateral weakness of hand grip, palmar, and dorsal interossei. There was also the significant weakness of the dorsiflexor of the feet with allodynia. Vibration and joint position sense were impaired in the distal lower limbs. Ankle reflexes were diminished. Nerve conduction studies showed nerve conduction block in three nerves. She also had abnormalities from motor and sensory nerve conduction studies involving multiple nerves. She showed remarkable improvements in her symptoms after a course of pulsed oral dexamethasone therapy.

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Section: Discussionmentioning

confidence: 99%

Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

Iyagba

Chioma

2017

Int J Adv Med

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“…autoimmune pathologies in a variety of experimental models (Munz et al, 2009) and have been reported to be temporally associated with the development of neurological deficits in CIDP patients (McCombe et al, 1987) (Bouchard et al, 1999). Due to their ability to cause persistent infections that periodically reactivate, human herpesviruses such as the alpha-herpesvirus herpes simplex virus (HSV), the beta-herpesvirus cytomegalovirus (HCMV) and the gamma-herpesvirus Epstein-Barr virus (EBV) are candidate triggers of autoimmune diseases development and exacerbation.…”

Section: Infectious Pathogens and Antiviral Immune Responses Triggermentioning

confidence: 99%

Dysregulated Epstein-Barr virus infection in patients with CIDP

Lünemann

Tackenberg

Stein

et al. 2010

Journal of Neuroimmunology

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Ubiquitous viruses have frequently been proposed as a cause or trigger of chronic immune-mediated diseases. Infections are reported to be temporally associated with clinical exacerbations in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). We examined immunological parameters of herpesvirus infections in untreated patients with CIDP compared to demographically matched controls. Patients with CIDP were uniformly seropositive for EBV-specific IgG and the disease was associated with a moderately enhanced IgG reactivity to EBV-encoded antigens expressed during both B cell transformation and productive viral replication. Moreover, cellular EBV copy numbers were 3-fold increased in patients with CIDP. In contrast, humoral immune responses to other herpesviruses (HCMV, HSV) as well as virus-specific IgM responses were unchanged in CIDP. These data indicate that host-pathogen interactions during chronic EBV infection are dysregulated in treatment-naïve patients with CIDP. Dysregulated Epstein-Barr Virus Infection in Patients with CIDP

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“…, 1999 ; Harbo, Andersen, Jakobsen, 2008; Said, 2006). Although the main pathology in CIDP is segmental demyelination, several studies demonstrated coexistence of axonal degeneration following segmental demyelination termed secondary axonal degeneration (Bouchard et al.…”

Section: Introductionmentioning

confidence: 99%

“…Although the main pathology in CIDP is segmental demyelination, several studies demonstrated coexistence of axonal degeneration following segmental demyelination termed secondary axonal degeneration (Bouchard et al. , 1999; Boukhris et al. , 2004 ; Said, 2006; Sghirlanzoni et al.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy

et al. 2017

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IntroductionIn chronic inflammatory demyelinating polyneuropathy (CIDP), exclusion of secondary axonal degeneration is challenging with conventional methods such as nerve conduction study (NCS), needle electromyography, and nerve biopsy. Increased echo intensity (EI) and decreased muscle thickness (MT) identified on muscle ultrasound (MUS) examination represent muscle denervation due to axonal degeneration in neurogenic disorders, suggesting MUS as a new tool to detect secondary axonal degeneration in patients with CIDP.Methods EI and MT of abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles were measured in 16 CIDP patients. Raw values were converted into z‐scores using data from 60 normal controls (NCs).ResultsSix of 45 muscles showed abnormally high EI and low MT, suggesting denervation following secondary axonal degeneration. These six muscles belonged to two patients with long disease history, unresponsiveness to treatment, and long interval from onset to initial therapy. There were no significant differences in EI and MT (p = .23 and .67, respectively) between the CIDP and NC groups, although NCS results revealed obvious demyelinating abnormalities in all CIDP patients, suggesting the fact that muscle structures will be preserved, and EI and MT will not change unless secondary axonal degeneration occurs in CIDP.Conclusion MUS is a promising tool for evaluating secondary axonal degeneration in patients with CIDP.

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Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy

Abstract: Axonal loss is the major long-term pejorative prognostic factor in CIDP.

Cited by 275 publications

References 33 publications

Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

Dysregulated Epstein-Barr virus infection in patients with CIDP

Quantitative muscle ultrasound is useful for evaluating secondary axonal degeneration in chronic inflammatory demyelinating polyneuropathy

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