Correlations between Electrophysiological Parameters, Lymphocyte Distribution and Cytokine Levels in Patients with Chronic Demyelinating Inflammatory Polyneuropathy

The goal of this study was to analyse, in relation to electrophysiological results, the distribution of lymphocyte subpopulations and the level of cytokines in patients with the typical form of chronic demyelinating inflammatory polyneuropathy (CIDP) before immunoglobulin treatment. The study group consisted of 60 patients (52 men, eight women), with a mean age 64.8 ± 11.2, who fulfilled the diagnostic criteria for the typical variant of CIDP, with (23 patients) and without (37 patients) diabetes mellitus. We analysed the results of the neurophysiological tests, and correlated them with the leukocyte subpopulations, and cytokine levels. In CIDP patients, IL-6, IL-2, IL-4 and TNF-α levels were significantly increased compared to the control group. Fifty patients had decreased levels of T CD8+ lymphocytes, and 51 patients had increased levels of CD4+ lymphocytes. An increased CD4+/CD8+ ratio was also found. Negative correlations were observed mainly between compound muscle action potential (CMAP) amplitudes and cytokine levels. The study enabled the conclusion that electrophysiological parameters in CIDP patients are closely related to the autoimmune process, but without any clear differences between patients with and without diabetes mellitus. Correlations found in the study indicated that axonal degeneration might be independent of the demyelinating process and might be caused by direct inflammatory infiltration.

Inflammatory demyelinating polyneuropathies in children

There are presented data on clinical variants and peculiarities of the course of acute demyelinating inflammatory polyneuropathy in children. This disease is the acute post-infectious immune-mediated polyradiculoneuropathy characterized by the destruction of myelin ofperipheral nerves and manifested by the syndrome of symmetrical polyneuropathy with motor, sensor, autonomous disturbances and albuminocytologic dissociation in cerebrospinal fluid. This disease is known to be commonly developed during 2-4 weeks with following stage of stabilization and then improvement. There are considered issues of etiology and pathogenesis of Guillian-Barre syndrome, with the accents on pediatric aspects. There are given data on chronic demyelinating inflammatory polyneuropathy andM. Fischer syndrome also. There are described neurophysiological criteria for demyelinating disorders in children and considered issues of their management.