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Tytuł pozycji:

Challenges in pediatric chronic inflammatory demyelinating polyneuropathy.

Tytuł :
Challenges in pediatric chronic inflammatory demyelinating polyneuropathy.
Autorzy :
Haliloğlu G; Department of Pediatric Neurology, Hacettepe University, Ankara, Turkey.
Yüksel D; Department of Pediatric Neurology, Sami Ulus Children's Hospital, Ankara, Turkey.
Temoçin CM; Department of Neurology, Hacettepe University, Ankara, Turkey.
Topaloğlu H; Department of Pediatric Neurology, Hacettepe University, Ankara, Turkey. Electronic address: .
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Źródło :
Neuromuscular disorders : NMD [Neuromuscul Disord] 2016 Dec; Vol. 26 (12), pp. 817-824. Date of Electronic Publication: 2016 Sep 22.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: Oxford ; New York : Pergamon Press, c1991-
MeSH Terms :
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/*diagnosis
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/*therapy
Adolescent ; Biomarkers/cerebrospinal fluid ; Child ; Child, Preschool ; Diagnostic Errors ; Electromyography ; Female ; Follow-Up Studies ; Humans ; Immunotherapy ; Male ; Neural Conduction ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/pathology ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/physiopathology ; Retrospective Studies ; Treatment Outcome
Contributed Indexing :
Keywords: Diagnosis; Pediatric chronic inflammatory demyelinating polyneuropathy
Substance Nomenclature :
0 (Biomarkers)
Entry Date(s) :
Date Created: 20161030 Date Completed: 20180126 Latest Revision: 20180126
Update Code :
20210209
DOI :
10.1016/j.nmd.2016.09.016
PMID :
27793469
Czasopismo naukowe
Chronic inflammatory demyelinating neuropathy, a treatable immune-mediated disease of the peripheral nervous system is less common in childhood compared to adults. Despite different sets of diagnostic criteria, lack of a reliable biologic marker leads to challenges in diagnosis, follow-up and treatment. Our first aim was to review clinical presentation, course, response to treatment, and prognosis in our childhood patients. We also aimed to document diagnostic and therapeutic pitfalls and challenges at the bedside. Our original cohort consisted of 23 pediatric patients who were referred to us with a clinical diagnosis of chronic inflammatory demyelinating neuropathy. Seven patients reaching to an alternative diagnosis were excluded. In the remaining patients, diagnostic, treatment and follow-up data were compared in typical patients who satisfied both clinical and electrodiagnostic criteria and atypical patients who failed to meet minimal research chronic inflammatory demyelinating neuropathy electrodiagnostic requirements. Eight of 16 patients (50%) met the minimal chronic inflammatory demyelinating neuropathy research diagnostic requirements. There was only a statistically significant difference (p = 0.010) in terms of European Neuromuscular Centre childhood chronic inflammatory diagnostic mandatory clinical criteria between the two groups. Misdiagnosis due to errors in electrophysiological interpretation (100%, n = 8), cerebrospinal fluid cytoalbuminologic dissociation (100%, n = 4 and/or subjective improvement on any immunotherapy modality (80 ± 19.27%)) was frequent. Pediatric CIDP is challenging in terms of diagnostic and therapeutic pitfalls at the bedside. Diagnostic errors due to electrophysiological interpretation, cerebrospinal fluid cytoalbuminologic dissociation, and/or subjective improvement on immunotherapy should be considered.
(Copyright © 2016 Elsevier B.V. All rights reserved.)
Erratum in: Neuromuscul Disord. 2017 May;27(5):e3. (PMID: 28283332)

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