Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?

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Title: Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?
Authors: Liberatore, G. (AUTHOR), Manganelli, F. (AUTHOR), Doneddu, P. E. (AUTHOR), Cocito, D. (AUTHOR), Fazio, R. (AUTHOR), Briani, C. (AUTHOR), Filosto, M. (AUTHOR), Benedetti, L. (AUTHOR), Mazzeo, A. (AUTHOR), Antonini, G. (AUTHOR), Cosentino, G. (AUTHOR), Jann, S. (AUTHOR), Cortese, A. (AUTHOR), Marfia, G. A. (AUTHOR), Clerici, A. M. (AUTHOR), Siciliano, G. (AUTHOR), Carpo, M. (AUTHOR), Luigetti, M. (AUTHOR), Lauria, G. (AUTHOR), Rosso, T. (AUTHOR)
Source: European Journal of Neurology. Feb2021, Vol. 28 Issue 2, p620-629. 10p.
Subjects: Diagnosis, European integration, Chronic inflammatory demyelinating polyradiculoneuropathy, Neural conduction, Cerebrospinal fluid, Peripheral nervous system
Abstract: Background and purpose: The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria. Methods: The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed. Results: In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty‐seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%). Conclusions: Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non‐diagnostic nerve conduction studies. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Chronic inflammatory demyelinating polyradiculoneuropathy: can a diagnosis be made in patients not fulfilling electrodiagnostic criteria?
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  Data: <searchLink fieldCode="AR" term="%22Liberatore%2C+G%2E%22">Liberatore, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Manganelli%2C+F%2E%22">Manganelli, F.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Doneddu%2C+P%2E+E%2E%22">Doneddu, P. E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cocito%2C+D%2E%22">Cocito, D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fazio%2C+R%2E%22">Fazio, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Briani%2C+C%2E%22">Briani, C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Filosto%2C+M%2E%22">Filosto, M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Benedetti%2C+L%2E%22">Benedetti, L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mazzeo%2C+A%2E%22">Mazzeo, A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Antonini%2C+G%2E%22">Antonini, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cosentino%2C+G%2E%22">Cosentino, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jann%2C+S%2E%22">Jann, S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cortese%2C+A%2E%22">Cortese, A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marfia%2C+G%2E+A%2E%22">Marfia, G. A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Clerici%2C+A%2E+M%2E%22">Clerici, A. M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Siciliano%2C+G%2E%22">Siciliano, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Carpo%2C+M%2E%22">Carpo, M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Luigetti%2C+M%2E%22">Luigetti, M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lauria%2C+G%2E%22">Lauria, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rosso%2C+T%2E%22">Rosso, T.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2021, Vol. 28 Issue 2, p620-629. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22European+integration%22">European integration</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+inflammatory+demyelinating+polyradiculoneuropathy%22">Chronic inflammatory demyelinating polyradiculoneuropathy</searchLink><br /><searchLink fieldCode="DE" term="%22Neural+conduction%22">Neural conduction</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebrospinal+fluid%22">Cerebrospinal fluid</searchLink><br /><searchLink fieldCode="DE" term="%22Peripheral+nervous+system%22">Peripheral nervous system</searchLink>
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  Data: Background and purpose: The aim was to identify the clinical and diagnostic investigations that may help to support a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) in patients not fulfilling the European Federation of Neurological Societies and Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria. Methods: The data from patients with a clinical diagnosis of CIDP included in a national database were retrospectively reviewed. Results: In all, 535 patients with a diagnosis of CIDP were included. This diagnosis fulfilled the EFNS/PNS criteria in 468 patients (87.2%) (definite in 430, probable in 33, possible in three, while two had chronic immune sensory polyradiculopathy). Sixty‐seven patients had a medical history and clinical signs compatible with CIDP but electrodiagnostic studies did not fulfill the EFNS/PNS criteria for CIDP. These patients had similar clinical features and frequency of abnormal supportive criteria for the diagnosis of CIDP compared to patients fulfilling EFNS/PNS criteria. Two or more abnormal supportive criteria were present in 40 (61.2%) patients rising to 54 (80.6%) if a history of a relapsing course as a possible supportive criterion was also included. Increased cerebrospinal fluid proteins and response to immune therapy most frequently helped in supporting the diagnosis of CIDP. Response to therapy was similarly frequent in patients fulfilling or not EFNS/PNS criteria (87.3% vs. 85.9%). Conclusions: Patients with a clinical diagnosis of CIDP had similar clinical findings, frequency of abnormal supportive criteria and response to therapy compared to patients fulfilling EFNS/PNS criteria. The presence of abnormal supportive criteria may help in supporting the diagnosis of CIDP in patients with a medical history and clinical signs compatible with this diagnosis but non‐diagnostic nerve conduction studies. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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