Chronic inflammatory demyelinating polyneuropathy in childhood: criteria for diagnosis and approaches to pathogenetic treatment
- Authors: Kurenkov A.L1, Bursagova B.I1, Kuzenkova L.M1, Pak L.A1, Uvakina E.V1
-
Affiliations:
- National Medical Research Center for Children's Health
- Issue: Vol 26, No 10 (2019)
- Pages: 21-26
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/312229
- DOI: https://doi.org/10.18565/pharmateca.2019.10.21-26
- ID: 312229
Cite item
Abstract
The article discusses the issues of diagnosis and treatment of chronic inflammatory demyelinating polyneuropathy (CIDP). The emphasis is placed on the clinical and electromyographic criteria for the diagnosis, and the features of the CIDP manifestations in childhood. Pathogenetic methods of treatment - intravenous immunotherapy with standard human immunoglobulin (IVIG), glucocorticosteroid therapy and plasmapheresis - are discussed from the standpoint of evidence-based medicine. The advantages of IVIG (high clinical efficacy, rapid onset of effect, good tolerability, multi-component mechanism of action with multiple points of application, the possibility of carrying out at any age) are emphasized when initiating therapy in children. The use of IVIG with a high 10% concentration of IgG is considered a priority, since it allows to reduce the volume load and provides a significant reduction in the duration of infusion.
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
A. L Kurenkov
National Medical Research Center for Children's Health
Email: alkurenkov@gmail.com
B. I Bursagova
National Medical Research Center for Children's Health
L. M Kuzenkova
National Medical Research Center for Children's Health
L. A Pak
National Medical Research Center for Children's Health
E. V Uvakina
National Medical Research Center for Children's Health
References
- McLeod J.G., Pollard J.D., Macaskill P, et al. Prevalence of chronic inflammatory demyelinating polyneuropathy in New South Wales, Australia. Ann Neurol. 1999;46(6):910-13.
- Joint Task Force of the EFNS and the PNS. European Federation of Neurological Societies/ Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society: First Revision. J Peripher Nerv Syst. 2010;15:1-9.
- Ryan M.M., Pollard J.D., Ouvrier R.A. Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy in childhood. In book: Inflammatory and autoimmune disorders of the nervous system in chilgren. Eds. Dale R.C., Vincent A. London: Mac Keith Press, 2010. P. 406-30.
- Nobile-Orazio E. Chronic inflammatory demyelinating polyradiculoneuropathy and variants: where we are and where we should go. J Peripher Nerv Syst. 2014;19(1):2-13.
- Doneddu P.E., Cocito D., Manganelli F., Fazio R., et al.; Italian CIDP Database study group. Atypical CIDP: diagnostic criteria, progression and treatment response. Data from the Italian CIDP Database. J Neurol Neurosurg Psychiatry. 2019;90(2):125-32. Doi:https://dx.doi.org/10.1136/jnnp-2018-318714.
- Вуйщик Н.Б., Супонева Н.А., Чечеткин А.О. и др. Ультразвуковая нейровизуализация при хронической воспалительной демиелинизирующей полиневропатии. Анналы неврологии. 2014;8(3):9-13
- Дружинин Д.С., Наумова Е.С., Никитин С.С. Ультразвуковая визуализация периферических нервов при мультифокальной моторной и хронической воспалительной демиелинизирующей полинейропатии. Нервно-мышечные болезни. 2016;6(1):63-73. Doi: https://dx.doi. org/10.17650/2222-8721-2016-6-1-63-73
- Padua L, Granata G, Sabatelli M, et al. Heterogeneity of root and nerve ultrasound pattern in CIDP patients. Clin Neurophysiol. 2014;125(1):160-65. Doi: https: //dx.doi.org/10.1016/j.clinph.2013.07.023.
- Nevo Y Childhood chronic inflammatory demyelinating polyneuropathy. Eur J Paediatr Neurol. 1998;2(4):169-77.
- McMillan H.J., Kang P.B., Jones H.R., Darras B.T. Childhood chronic inflammatory demyelinating polyradiculoneuropathy: combined analysis of a large cohort and eleven published series. Neuromuscul Disord. 2013;23(2): 103-11.
- Silwal A., Pitt M., Phadke R., et al. Clinical spectrum, treatment and outcome of children with suspected diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy. Neuromuscul Disord. 2018;28(9):757-65. Doi: https: //dx.doi. org/10.1016/j.nmd.2018.06.001.
- Harada Y, Herrmann D.N., logigian E.L. Pediatric CIDP: clinical features and response to treatment. J Clin Neuromuscul Dis. 2017;19(2):57-65. Doi: https://dx.doi.org/10.1097/ CND.0000000000000179.
- Simmons Z., Wald J.J., Albers J.W. Chronic inflammatory demyelinating polyradiculoneuropathy in children: II. Long-term follow-up, with comparison to adults. Muscle Nerve. 1997;20(12):1569-75.
- Rabie M., Nevo Y Childhood acute and chronic immune-mediated polyradiculoneuropathies. Eur J Paediatr Neurol. 2009;13(3):209-18. Doi: https: //dx.doi.org/10.1016/j.ejpn.2008.04.009.
- Куренков А.Л., Никитин С.С., Бурсагова Б.И., Кузенкова Л.М. Особенности хронической воспалительной демиелинизирующей полиневропатии у детей. Нервно-мышечные болезни. 2012;2:40-51
- Супонева Н.А., Наумова Е.С., Гнедовская Е.В. Хроническая воспалительная демиелинизирующая полинейропатия у взрослых: принципы диагностики и терапия первой линии. Нервно-мышечные болезни. 2016;6(1):44-53. Doi: https: //dx.doi.org/10.17650/2222-8721-2016-6-1-44-53
- Bansal V.K., Meriggioli M.N. Immunotherapy in the treatment autoimmune neuromuscular disease. In book: Neuromuscular disorders in clinical practice. Eds. Katirji B., Kaminski H.J., Ruff R.L. New York: Springer, 2014. P 341-62.
- Cocito D., Grimaldi S., Paolasso I., Falcone Y., et al. Immunosuppressive treatment in refractory chronic inflammatory demyelinating polyradiculoneuropathy. A nationwide retrospective analysis. Eur J Neurol. 2011;18:1417-21.
- Mahdi-Rogers M., Brassington R., Gunn A.A., et al. Immunomodulatory treatment other than corticosteroids, immunoglobulin and plasma exchange for chronic inflammatory demyelinating polyradiculoneuropathy. Cochrane Database Syst Rev. 2017;5:CD003280. Doi: https: //dx.doi. org/10.1002/14651858.CD003280.pub5.
- Oaklander A.L., Lunn M.P, Hughes R.A., et al. Treatments for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): an overview of systematic reviews. Cochrane Database Syst Rev. 2017;1:CD010369. Doi: https: //dx.doi. org/10.1002/14651858.CD010369.pub2.
- Куренков А.Л., Кузенкова Л.М., Никитин С.С., Бурсагова Б.И. Хроническая воспалительная демиелинизирующая полиневропатия у детей: диагностика и лечение. Вопросы современной педиатрии. 2014;13(5):34-41
- Куренков А.Л., Кузенкова Л.М., Никитин С.С. и др. Хронические воспалительные демиелинизирующиея полиневропатии у детей. В кн.: Федеральное руководство по детской неврологии / Под ред. В.И. Гузевой. М., 2016. C. 43743
- Leger J.M., De Bleecker J.L., Sommer C., et al.; PRIMA study investigators. Efficacy and safety of Privigen® in patients with chronic inflammatory demyelinating polyneuropathy: results of a prospective, single-arm, open-label Phase III study (the PRIMA study). J Peripher Nerv Syst. 2013;18(2):130-40. Doi: https: //dx.doi. org/10.1111/jns5.12017.
- Gadian J., Kirk E., Holliday K., et al. Systematic review of immunoglobulin use in paediatric neurological and neurodevelopmental disorders. Dev Med Child Neurol. 2017;59(2):136-44. Doi: https: //dx.doi.org/10.1111/dmcn. 13349.
- Hughes R.A., Mehndiratta M.M., Rajabally Y.A. Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy Cochrane Database Syst Rev. 2017;11:CD002062. Doi: https: //dx.doi.org/10.1002/14651858. CD002062.pub4.
- Sladky J.T. What is the best initial treatment for childhood chronic inflammatory demyelinating polyneuropathy: corticosteroids or intravenous immunoglobulin? Muscle Nerve. 2008;38(6):1638-43. Doi: https: //dx.doi. org/10.1002/mus.21058.
- Mehndiratta M.M., Hughes R.A., Pritchard J. Plasma exchange for chronic inflammatory demyelinating polyradiculoneuropathy Cochrane Database Syst Rev. 2015;(8):CD003906. Doi: https://dx.doi. org/10.1002/14651858.CD003906.pub4.
Supplementary files
![](/img/style/loading.gif)