Diagnostic challenges in chronic inflammatory demyelinating polyradiculoneuropathy
Eftimov, Filip (University of Amsterdam)
Lucke, Ilse M. (University of Amsterdam)
Querol, Luis (Institut d'Investigació Biomèdica Sant Pau)
Rajabally, Yusuf A. (Aston University)
Verhamme, Camiel (University of Amsterdam)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) consists of a spectrum of autoimmune diseases of the peripheral nerves, causing weakness and sensory symptoms. Diagnosis often is challenging, because of the heterogeneous presentation and both mis- and underdiagnosis are common. Nerve conduction study (NCS) abnormalities suggestive of demyelination are mandatory to fulfil the diagnostic criteria. On the one hand, performance and interpretation of NCS can be difficult and none of these demyelinating findings are specific for CIDP. On the other hand, not all patients will be detected despite the relatively high sensitivity of NCS abnormalities. The electrodiagnostic criteria can be supplemented with additional diagnostic tests such as CSF examination, MRI, nerve biopsy, and somatosensory evoked potentials. However, the evidence for each of these additional diagnostic tests is limited. Studies are often small without the use of a clinically relevant control group. None of the findings are specific for CIDP, meaning that the results of the diagnostic tests should be carefully interpreted. In this update we will discuss the pitfalls in diagnosing CIDP and the value of newly introduced diagnostic tests such as nerve ultrasound and testing for autoantibodies, which are not yet part of the guidelines.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	CIDP ; Diagnostic accuracy ; Diagnostic pitfalls ; Misdiagnosis ; Underdiagnosis
Publicat a:	Brain, Vol. 143 Núm. 11 (2021) , p. 3214-3224, ISSN 1460-2156

DOI: 10.1093/BRAIN/AWAA265
PMID: 33155018

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