Inflammatory polyneuropathy

From Citizendium
Revision as of 16:40, 31 January 2010 by imported>Howard C. Berkowitz
Jump to navigation Jump to search
This article is developing and not approved.
Main Article
Discussion
Definition [?]
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and subject to a disclaimer.

Inflammatory polyneuropathy covers a range of syndromes, both acute and chronic.

Clinical and experimental findings suggest that humoral factors, such as anti-peripheral nerve antibodies and cytokines, may be implicated in the immunopathogenesis of Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Interleukin-6 (IL-6) is a multifunctional cytokine that promotes immunoglobulin synthesis by B lymphocytes. Inflammatory substances generated include interleukin-6; increased IL-6 release is associated with autoantibody production in a number of immune-mediated and neoplastic disorders. [1]

Chronic Inflammatory Polyradiculoneuropathy

A slowly progressive autoimmune demyelinating disease of peripheral nerves and nerve roots. Clinical manifestations include weakness and sensory loss in the extremities and enlargement of peripheral nerves. The course may be relapsing-remitting or demonstrate a step-wise progression. Protein is usually elevated in the spinal fluid and cranial nerves are typically spared. Guillain-Barre syndrome features a relatively rapid progression of disease which distinguishes it from this condition. [2]

Intravenous immune globulin has been reported to improve quality of life. [3]

Guillain-Barre syndrome

An acute inflammatory autoimmune neuritis caused by T cell- mediated cellular immune response directed towards peripheral myelin. Demyelination occurs in peripheral nerves and nerve roots. The process is often preceded by a viral or bacterial infection, surgery, immunization, lymphoma, or exposure to toxins. Common clinical manifestations include progressive weakness, loss of sensation, and loss of deep tendon reflexes. Weakness of respiratory muscles and autonomic dysfunction may occur.

References

  1. D. Maimone, P. Annunziata, I. Simone, P. Livrea, G. Guazzi, "Interleukin-6 levels in the cerebrospinal fluid and serum of patients with Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy", Journal of Neuroimmunology 47 (1): 55-61
  2. Adams et al., Principles of Neurology, 6th ed, p. 1337
  3. ISJ Merkies, Neurology 2009 Apr 14; 72:1337, Immune Globulin Helpful in Polyradiculoneuropathy