TY - JOUR
T1 - Chronic inflammatory demyelinating polyneuropathy in diabetes patients
AU - Abraham, Alon
AU - Alabdali, Majed
AU - Qrimli, Mohammad
AU - Breiner, Ari
AU - Barnett, Carolina
AU - Katzberg, Hans D.
AU - Perkins, Bruce A.
AU - Bril, Vera
PY - 2015
Y1 - 2015
N2 - Diabetes mellitus (DM) is pandemic, and is the leading global cause of polyneuropathy, most commonly, a distal symmetric sensorimotor polyneuropathy (DSP). By contrast, chronic inflammatory demyelinating polyneuropathy (CIDP) is rare, and characterized mainly by symmetrical proximal and distal muscles weakness. There are currently 15 sets of criteria using a variable combination of clinical, electrophysiologic, laboratory, and biopsy features to identify CIDP, but it is unclear if these criteria are the same in patients with and without DM. Slowed conduction velocity, a feature of demyelination, is observed in patients with type 1 DM with poor control, and the clinical characteristics of these patients differ from those who have CIDP and DM, suggesting a different pathophysiology. Treatment response rates in CIDP patients, with and without DM, are as high as 80 %, and it is recommended that treatment be started early to prevent secondary axonal loss. However, patients with type 1 DM with CIDP are far less likely to be treated than CIDP patients who do not have DM. In patients with type 1 DM with polyneuropathy who have prominent weakness or demyelination in electrophysiologic studies, a diagnosis of CIDP and a trial of therapy should be considered.
AB - Diabetes mellitus (DM) is pandemic, and is the leading global cause of polyneuropathy, most commonly, a distal symmetric sensorimotor polyneuropathy (DSP). By contrast, chronic inflammatory demyelinating polyneuropathy (CIDP) is rare, and characterized mainly by symmetrical proximal and distal muscles weakness. There are currently 15 sets of criteria using a variable combination of clinical, electrophysiologic, laboratory, and biopsy features to identify CIDP, but it is unclear if these criteria are the same in patients with and without DM. Slowed conduction velocity, a feature of demyelination, is observed in patients with type 1 DM with poor control, and the clinical characteristics of these patients differ from those who have CIDP and DM, suggesting a different pathophysiology. Treatment response rates in CIDP patients, with and without DM, are as high as 80 %, and it is recommended that treatment be started early to prevent secondary axonal loss. However, patients with type 1 DM with CIDP are far less likely to be treated than CIDP patients who do not have DM. In patients with type 1 DM with polyneuropathy who have prominent weakness or demyelination in electrophysiologic studies, a diagnosis of CIDP and a trial of therapy should be considered.
KW - CIDP
KW - CSF
KW - Diabetic neuropathy
KW - Distal symmetric polyneuropathy
KW - Nerve biopsy
UR - http://www.scopus.com/inward/record.url?scp=85042807073&partnerID=8YFLogxK
U2 - 10.17925/usn.2015.11.01.47
DO - 10.17925/usn.2015.11.01.47
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:85042807073
SN - 1758-4000
VL - 11
SP - 47
EP - 52
JO - US Neurology
JF - US Neurology
IS - 1
ER -