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Childhood acute and chronic immune-mediated polyradiculoneuropathies.
Eur J Paediatr Neurol. 2009 May; 13(3):209-18.EJ

Abstract

Immune-mediated polyradiculoneuropathies are divided into Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). In children subacute inflammatory demyelinating polyradiculoneuropathy is included in CIDP. Immune polyradiculoneuropathies are not exclusively demyelinating, and axonal forms also responding favourably to immunotherapy occur. Evidence-based data on efficacy of therapy in children is lacking, relying on retrospective data, open label studies on small numbers of children, and mainly adult derived data. Immunotherapy (intravenous human immunoglobulin [IVIg] and plasmapheresis) shortens GBS recovery time with most children recovering completely. Childhood CIDP usually responds to corticosteroids and slow tapering is required to prevent relapses. IVIg and plasmapheresis are also effective. CIDP children resistant to steroids, IVIg, and steroid-dependent patients present a therapeutic challenge. Immunosuppressive agents including methotrexate, azathioprine and cyclosporine are helpful in some cases. Anecdotal reports of treatment with interferons alpha or beta and monoclonal antibodies against specific B-cell antigens (Rituximab, Alemtuzumab) have been described in limited case reports. Childhood CIDP prognosis is mostly favourable. However, a proportion of cases have residual neurological deficit.

Authors+Show Affiliations

Hadassah Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel. rabie007@bezeqint.netNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18585069

Citation

Rabie, Malcolm, and Yoram Nevo. "Childhood Acute and Chronic Immune-mediated Polyradiculoneuropathies." European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, vol. 13, no. 3, 2009, pp. 209-18.
Rabie M, Nevo Y. Childhood acute and chronic immune-mediated polyradiculoneuropathies. Eur J Paediatr Neurol. 2009;13(3):209-18.
Rabie, M., & Nevo, Y. (2009). Childhood acute and chronic immune-mediated polyradiculoneuropathies. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 13(3), 209-18. https://doi.org/10.1016/j.ejpn.2008.04.009
Rabie M, Nevo Y. Childhood Acute and Chronic Immune-mediated Polyradiculoneuropathies. Eur J Paediatr Neurol. 2009;13(3):209-18. PubMed PMID: 18585069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood acute and chronic immune-mediated polyradiculoneuropathies. AU - Rabie,Malcolm, AU - Nevo,Yoram, Y1 - 2008/06/26/ PY - 2008/02/21/received PY - 2008/04/26/revised PY - 2008/04/30/accepted PY - 2008/7/1/pubmed PY - 2009/7/2/medline PY - 2008/7/1/entrez SP - 209 EP - 18 JF - European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society JO - Eur. J. Paediatr. Neurol. VL - 13 IS - 3 N2 - Immune-mediated polyradiculoneuropathies are divided into Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). In children subacute inflammatory demyelinating polyradiculoneuropathy is included in CIDP. Immune polyradiculoneuropathies are not exclusively demyelinating, and axonal forms also responding favourably to immunotherapy occur. Evidence-based data on efficacy of therapy in children is lacking, relying on retrospective data, open label studies on small numbers of children, and mainly adult derived data. Immunotherapy (intravenous human immunoglobulin [IVIg] and plasmapheresis) shortens GBS recovery time with most children recovering completely. Childhood CIDP usually responds to corticosteroids and slow tapering is required to prevent relapses. IVIg and plasmapheresis are also effective. CIDP children resistant to steroids, IVIg, and steroid-dependent patients present a therapeutic challenge. Immunosuppressive agents including methotrexate, azathioprine and cyclosporine are helpful in some cases. Anecdotal reports of treatment with interferons alpha or beta and monoclonal antibodies against specific B-cell antigens (Rituximab, Alemtuzumab) have been described in limited case reports. Childhood CIDP prognosis is mostly favourable. However, a proportion of cases have residual neurological deficit. SN - 1532-2130 UR - https://www.unboundmedicine.com/medline/citation/18585069/Childhood_acute_and_chronic_immune_mediated_polyradiculoneuropathies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1090-3798(08)00099-8 DB - PRIME DP - Unbound Medicine ER -