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Immunotherapy of idiopathic inflammatory neuropathies.
Muscle Nerve. 2003 Sep; 28(3):273-92.MN

Abstract

Evaluation of peripheral neuropathy is a common reason for referral to a neurologist. Recent advances in immunology have identified an inflammatory component in many neuropathies and have led to treatment trials using agents that attenuate this response. This article reviews the clinical presentation and treatment of the most common subacute inflammatory neuropathies, Guillain-Barré syndrome (GBS) and Fisher syndrome, and describes the lack of response to corticosteroids and the efficacy of treatment with plasma exchange and intravenous immunoglobulin (IVIG). Chronic inflammatory demyelinating polyneuropathy, although sharing some clinical, electrodiagnostic, and pathologic similarities to GBS, improves after treatment with plasma exchange and IVIG and numerous immunomodulatory agents. Controlled trials in multifocal motor neuropathy have shown benefit after treatment with IVIG and cyclophosphamide. Also discussed is the treatment of less common inflammatory neuropathies whose pathophysiology involves monoclonal proteins or antibodies directed against myelin-associated glycoprotein or sulfatide. Little treatment data exist to direct the clinician to proper management of rare inflammatory neuropathies resulting from osteosclerotic myeloma; POEMS syndrome; vasculitis; Sjögren's syndrome; and neoplasia (paraneoplastic neuropathy).

Authors+Show Affiliations

Department of Neurology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1078, USA. donofrio@wfubmc.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12929187

Citation

Donofrio, Peter D.. "Immunotherapy of Idiopathic Inflammatory Neuropathies." Muscle & Nerve, vol. 28, no. 3, 2003, pp. 273-92.
Donofrio PD. Immunotherapy of idiopathic inflammatory neuropathies. Muscle Nerve. 2003;28(3):273-92.
Donofrio, P. D. (2003). Immunotherapy of idiopathic inflammatory neuropathies. Muscle & Nerve, 28(3), 273-92.
Donofrio PD. Immunotherapy of Idiopathic Inflammatory Neuropathies. Muscle Nerve. 2003;28(3):273-92. PubMed PMID: 12929187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunotherapy of idiopathic inflammatory neuropathies. A1 - Donofrio,Peter D, PY - 2003/8/21/pubmed PY - 2003/9/27/medline PY - 2003/8/21/entrez SP - 273 EP - 92 JF - Muscle & nerve JO - Muscle Nerve VL - 28 IS - 3 N2 - Evaluation of peripheral neuropathy is a common reason for referral to a neurologist. Recent advances in immunology have identified an inflammatory component in many neuropathies and have led to treatment trials using agents that attenuate this response. This article reviews the clinical presentation and treatment of the most common subacute inflammatory neuropathies, Guillain-Barré syndrome (GBS) and Fisher syndrome, and describes the lack of response to corticosteroids and the efficacy of treatment with plasma exchange and intravenous immunoglobulin (IVIG). Chronic inflammatory demyelinating polyneuropathy, although sharing some clinical, electrodiagnostic, and pathologic similarities to GBS, improves after treatment with plasma exchange and IVIG and numerous immunomodulatory agents. Controlled trials in multifocal motor neuropathy have shown benefit after treatment with IVIG and cyclophosphamide. Also discussed is the treatment of less common inflammatory neuropathies whose pathophysiology involves monoclonal proteins or antibodies directed against myelin-associated glycoprotein or sulfatide. Little treatment data exist to direct the clinician to proper management of rare inflammatory neuropathies resulting from osteosclerotic myeloma; POEMS syndrome; vasculitis; Sjögren's syndrome; and neoplasia (paraneoplastic neuropathy). SN - 0148-639X UR - https://www.unboundmedicine.com/medline/citation/12929187/Immunotherapy_of_idiopathic_inflammatory_neuropathies_ L2 - https://doi.org/10.1002/mus.10402 DB - PRIME DP - Unbound Medicine ER -