Diagnostic criteria and therapeutic implications of rapid-onset demyelinating polyneuropathies

Exp Mol Pathol. 2024 Dec:140:104942. doi: 10.1016/j.yexmp.2024.104942. Epub 2024 Nov 4.

Abstract

Guillain-Barré syndrome (GBS) and acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) are the most common autoimmune polyneuropathies. Their aetiology is unclear. The pathomechanism includes damage mainly to the myelin sheath and, in the long-term process, secondary axonal loss. Both inflammatory polyneuropathies involve different combinations of motor, sensory and autonomic fibres in the peripheral nerves. The differential diagnosis should be based on clinical and neurophysiological features, and laboratory tests. Numerous studies aim to demonstrate the most common errors in the diagnosis of Guillain-Barré syndrome and acute-onset CIDP. Misdiagnosis can result in the wrong treatment. We still do not have reliable markers to help diagnose the disease or to monitor the effectiveness of the therapy.

Keywords: Acute-onset chronic inflammatory demyelinating polyneuropathy; Biomarkers; Guillain-Barré syndrome; Inflammatory polyneuropathies; Neurophysiological features.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Guillain-Barre Syndrome* / diagnosis
  • Guillain-Barre Syndrome* / pathology
  • Guillain-Barre Syndrome* / therapy
  • Humans
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / therapy