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Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia

Authorized Users Only
2023
Authors
Basta, Ivana
Delić, Neda
Gunjić, Ilija
Arsenijević Zdraljević, Mirjana
Kačar, Aleksandra
Božović, Ivo
Perić, Stojan
Article (Published version)
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Abstract
Making diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is challenging since it can mimic a multitude of disorders, and is misdiagnosed in at least 50% of cases. We sought to determine the frequency of CIDP misdiagnosis in clinical practice in Serbia, to uncover CIDP mimics, and to identify factors that may aid in CIDP diagnosis. Our longitudinal retrospective cohort study included 86 eligible adult patients referred to the Neurology Clinic, University Clinical Centre of Serbia, with a diagnosis of CIDP. We also included 15 patients referred to us with different diagnoses that ended up having CIDP as their final diagnosis. Exactly half of patients referred as CIDP failed to meet the established diagnostic criteria (non-CIDP) and were given an alternative diagnosis at the first hospitalization. At the 1-year follow-up, the diagnosis was further revised in four subjects. Confirmed CIDP patients usually had their initial diagnosis based on the nerve conduction... studies (NCS), a typical presentation with symmetrical involvement of all four limbs, as well as higher frequencies of elevated protein levels and albuminocytologic dissociation in the cerebrospinal fluid (CSF). CIDP patients also responded better to immune therapy. We found that 52% of the patients initially referred to our Clinic as CIDP were given other diagnoses after a 1-year follow-up. Out of all CIDP cases, 27% had been unrecognized prior to referral to our Center. Utilization of clear and objective indicators - conclusive NCS, improvement on therapy, and elevated CSF proteins may provide greater certainty in diagnosing CIDP.

Keywords:
chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) / diagnostic criteria / diagnostic errors / misdiagnosis / nerve conduction studies
Source:
Journal of the Peripheral Nervous System, 2023
Publisher:
  • John Wiley and Sons Inc

DOI: 10.1111/jns.12537

ISSN: 1085-9489

PubMed: 36738239

WoS: 000930468300001

Scopus: 2-s2.0-85148093887
[ Google Scholar ]
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/4436
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Basta, Ivana
AU  - Delić, Neda
AU  - Gunjić, Ilija
AU  - Arsenijević Zdraljević, Mirjana
AU  - Kačar, Aleksandra
AU  - Božović, Ivo
AU  - Perić, Stojan
PY  - 2023
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/4436
AB  - Making diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is challenging since it can mimic a multitude of disorders, and is misdiagnosed in at least 50% of cases. We sought to determine the frequency of CIDP misdiagnosis in clinical practice in Serbia, to uncover CIDP mimics, and to identify factors that may aid in CIDP diagnosis. Our longitudinal retrospective cohort study included 86 eligible adult patients referred to the Neurology Clinic, University Clinical Centre of Serbia, with a diagnosis of CIDP. We also included 15 patients referred to us with different diagnoses that ended up having CIDP as their final diagnosis. Exactly half of patients referred as CIDP failed to meet the established diagnostic criteria (non-CIDP) and were given an alternative diagnosis at the first hospitalization. At the 1-year follow-up, the diagnosis was further revised in four subjects. Confirmed CIDP patients usually had their initial diagnosis based on the nerve conduction studies (NCS), a typical presentation with symmetrical involvement of all four limbs, as well as higher frequencies of elevated protein levels and albuminocytologic dissociation in the cerebrospinal fluid (CSF). CIDP patients also responded better to immune therapy. We found that 52% of the patients initially referred to our Clinic as CIDP were given other diagnoses after a 1-year follow-up. Out of all CIDP cases, 27% had been unrecognized prior to referral to our Center. Utilization of clear and objective indicators - conclusive NCS, improvement on therapy, and elevated CSF proteins may provide greater certainty in diagnosing CIDP.
PB  - John Wiley and Sons Inc
T2  - Journal of the Peripheral Nervous System
T1  - Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia
DO  - 10.1111/jns.12537
ER  - 
@article{
author = "Basta, Ivana and Delić, Neda and Gunjić, Ilija and Arsenijević Zdraljević, Mirjana and Kačar, Aleksandra and Božović, Ivo and Perić, Stojan",
year = "2023",
abstract = "Making diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is challenging since it can mimic a multitude of disorders, and is misdiagnosed in at least 50% of cases. We sought to determine the frequency of CIDP misdiagnosis in clinical practice in Serbia, to uncover CIDP mimics, and to identify factors that may aid in CIDP diagnosis. Our longitudinal retrospective cohort study included 86 eligible adult patients referred to the Neurology Clinic, University Clinical Centre of Serbia, with a diagnosis of CIDP. We also included 15 patients referred to us with different diagnoses that ended up having CIDP as their final diagnosis. Exactly half of patients referred as CIDP failed to meet the established diagnostic criteria (non-CIDP) and were given an alternative diagnosis at the first hospitalization. At the 1-year follow-up, the diagnosis was further revised in four subjects. Confirmed CIDP patients usually had their initial diagnosis based on the nerve conduction studies (NCS), a typical presentation with symmetrical involvement of all four limbs, as well as higher frequencies of elevated protein levels and albuminocytologic dissociation in the cerebrospinal fluid (CSF). CIDP patients also responded better to immune therapy. We found that 52% of the patients initially referred to our Clinic as CIDP were given other diagnoses after a 1-year follow-up. Out of all CIDP cases, 27% had been unrecognized prior to referral to our Center. Utilization of clear and objective indicators - conclusive NCS, improvement on therapy, and elevated CSF proteins may provide greater certainty in diagnosing CIDP.",
publisher = "John Wiley and Sons Inc",
journal = "Journal of the Peripheral Nervous System",
title = "Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia",
doi = "10.1111/jns.12537"
}
Basta, I., Delić, N., Gunjić, I., Arsenijević Zdraljević, M., Kačar, A., Božović, I.,& Perić, S.. (2023). Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia. in Journal of the Peripheral Nervous System
John Wiley and Sons Inc..
https://doi.org/10.1111/jns.12537
Basta I, Delić N, Gunjić I, Arsenijević Zdraljević M, Kačar A, Božović I, Perić S. Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia. in Journal of the Peripheral Nervous System. 2023;.
doi:10.1111/jns.12537 .
Basta, Ivana, Delić, Neda, Gunjić, Ilija, Arsenijević Zdraljević, Mirjana, Kačar, Aleksandra, Božović, Ivo, Perić, Stojan, "Chronic inflammatory demyelinating polyradiculoneuropathy: Diagnostic problems in clinical practice in Serbia" in Journal of the Peripheral Nervous System (2023),
https://doi.org/10.1111/jns.12537 . .

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