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Immune-mediated neuropathy

Kazue Hisaoka-Nakashima, Yoshiaki Tomimura, Toshiki Yoshii, Kazuto Ohata, Naoki Takada, Fang Fang Zhang, Yoki Nakamura, Keyue Liu, Hidenori Wake, Masahiro Nishibori, Yoshihiro Nakata, Norimitsu Morioka
Clinical evidence indicates that major depression is a common comorbidity of chronic pain, including neuropathic pain. However, the cellular basis for chronic pain-mediated major depression remains unclear. High-mobility group box 1 protein (HMGB1) has a key role in innate immune responses and appears to be have a role in mediating diverse disorders, including neuropathic pain and depression. The current study aimed to characterize neuropathic pain-induced changes in affect over time and to determine whether HMGB1 has a role in neuropathic pain-induced changes in affect...
February 11, 2019: Progress in Neuro-psychopharmacology & Biological Psychiatry
Peng Soon Ng, Peter J Dyck, Ruple S Laughlin, Prabin Thapa, Marcus V Pinto, P James B Dyck
OBJECTIVE: To determine the previously unknown incidence of lumbosacral-radiculoplexus neuropathy (LRPN) and its association with diabetes mellitus (DM). METHODS: LRPN defined by clinical and electrophysiologic criteria was identified among Olmsted County, Minnesota, residents during a 16-year period (2000-2015) using the unique facilities of the Rochester Epidemiology Project. DM was ascertained using American Diabetes Association criteria. RESULTS: Of 1,892 medical records reviewed, 59 patients (33 men, 26 women) were identified as having LRPN...
February 13, 2019: Neurology
Elizabeth S Mearns, Aliki Taylor, Kelly J Thomas Craig, Stefanie Puglielli, Daniel A Leffler, David S Sanders, Benjamin Lebwohl, Marios Hadjivassiliou
Celiac disease (CD) is an immune-mediated gastrointestinal disorder driven by innate and adaptive immune responses to gluten. Patients with CD are at an increased risk of several neurological manifestations, frequently peripheral neuropathy and gluten ataxia. A systematic literature review of the most commonly reported neurological manifestations (neuropathy and ataxia) associated with CD was performed. MEDLINE, Embase, the Cochrane Library, and conference proceedings were systematically searched from January 2007 through September 2018...
February 12, 2019: Nutrients
Alexander J Davies, Hyoung Woo Kim, Rafael Gonzalez-Cano, Jahyang Choi, Seung Keun Back, Seung Eon Roh, Errin Johnson, Melanie Gabriac, Mi-Sun Kim, Jaehee Lee, Jeong Eun Lee, Yun Sook Kim, Yong Chul Bae, Sang Jeong Kim, Kyung-Mi Lee, Heung Sik Na, Priscilla Riva, Alban Latremoliere, Simon Rinaldi, Sophie Ugolini, Michael Costigan, Seog Bae Oh
Sensory axons degenerate following separation from their cell body, but partial injury to peripheral nerves may leave the integrity of damaged axons preserved. We show that an endogenous ligand for the natural killer (NK) cell receptor NKG2D, Retinoic Acid Early 1 (RAE1), is re-expressed in adult dorsal root ganglion neurons following peripheral nerve injury, triggering selective degeneration of injured axons. Infiltration of cytotoxic NK cells into the sciatic nerve by extravasation occurs within 3 days following crush injury...
January 25, 2019: Cell
Naama Yosha-Orpaz, Sharon Aharoni, Malcolm Rabie, Yoram Nevo
Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. During the acute phase, the disorder can be life-threatening by involving the respiratory muscles and the autonomic nervous system. Nevertheless, the prognosis is good, and most children achieve full recovery. The aim of this study was to characterize the clinical and electrophysiologic findings in children with Guillain-Barré syndrome referred to a tertiary center in Israel. A retrospective database review from 2009 to 2015 identified 39 children...
January 23, 2019: Journal of Child Neurology
Eric Anthony Coomes, Hourmazd Haghbayan, Jenna Spring, Sangeeta Mehta
A 45-year-old man with a history of systemic lupus erythematosus presented with progressive weakness and areflexia. Electromyogram revealed reduced motor and sensory amplitudes without demyelinating features. He was clinically diagnosed with the acute motor and sensory axonal neuropathy variant of Guillain-Barré syndrome. Despite intravenous immunoglobulin therapy, he deteriorated with loss of all voluntary motor function and cranial nerve reflexes. Concomitant investigations revealed class V lupus nephritis...
January 14, 2019: BMJ Case Reports
Ilse M Lucke, Max E Adrichem, Luuk Wieske, Anneke J van der Kooi, Camiel Verhamme, Ivo N van Schaik, Filip Eftimov
Intravenous immunoglobulins (IVIg) are an efficacious treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN). IVIg is considered in patients who have a high suspicion of an inflammatory neuropathy, but do not meet diagnostic criteria. The objective of this retrospective study was to assess which diagnostic results led to the decision to administer IVIg and to determine the rate of improvement. We included consecutive patients suspected of CIDP or MMN who did not meet the electrophysiological EFNS/PNS criteria and received IVIg treatment...
December 31, 2018: Journal of the Neurological Sciences
Laura F Santoso, Daniel Y Kim, David Paydarfar
BACKGROUND: Although sensory feedback is a vital regulator of deglutition, it is not comprehensively considered in the standard dysphagia evaluation. Difficulty swallowing secondary to sensory loss may be termed "sensory dysphagia" and may account for cases receiving diagnoses of exclusion, like functional or idiopathic dysphagia. METHODS AND RESULTS: Three cases of idiopathic dysphagia were suspected to have sensory dysphagia. The patients had (1) effortful swallowing, (2) globus sensation, and (3) aspiration...
January 8, 2019: Head & Neck
Todd D Levine, Jonathan S Katz, Richard Barohn, Leslie J Vaughan, Mazen M Dimachkie, David S Saperstein, Tahseen Mozaffar, Gil I Wolfe, Matthew S Mayo, Gary J Badger, Lara Katzin, Elissa Ritt, Michelle Greer, Joseph DiStefano, Patrick M Schmidt
Background: This project is an effort to understand how orders for IV immunoglobulin (IVIg) are documented and prescribed by physicians, and subsequently, how they are reviewed by insurance companies for the treatment of immune neuropathies. Methods: A panel of neuromuscular specialists reviewed case records from 248 IVIg-naive patients whose in-home IVIg infusion treatment was submitted to insurance for authorization. After reviewing a case record, 1 panelist was asked to make a diagnosis and to answer several questions about the treatment...
October 2018: Neurology. Clinical Practice
Hsin-Pin Lin, Kwo Wei David Ho, Miguel Chuquilin
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired disorder of peripheral nerves and nerve roots. Its cause is unknown, but recently antibodies to nodal and paranodal proteins have been discovered in a small subset of CIDP patients. These contactin and neurofascin-related immune-mediated neuropathies are thought to be variants of CIDP and often respond suboptimally to standard therapy. Here, we report a patient with both anti-contactin 1 and anti-neurofascin 140 antibodies whose presentation resembled phenotypes of both CIDP variants...
December 2018: ENeurologicalSci
Renato D'Alonzo, Elisabetta Mencaroni, Lorenza Di Genova, Daniela Laino, Nicola Principi, Susanna Esposito
Mycoplasma pneumoniae is mainly recognized as a respiratory pathogen, although it is associated with the development of several extra-respiratory conditions in up to 25% of the cases. Diseases affecting the nervous system, both the peripheral (PNS) and the central nervous system (CNS), are the most severe. In some cases, particularly those that involve the CNS, M. pneumoniae -related neuropathies can lead to death or to persistent neurologic problems with a significant impact on health and a non-marginal reduction in the quality of life of the patients...
2018: Frontiers in Microbiology
Svetlana Blitshteyn, Louise Brinth, Jeanne E Hendrickson, Manuel Martinez-Lavin
This article reviews the case series reported from several countries describing patients with suspected severe side effects to the HPV vaccines. The described symptom clusters are remarkably similar and include disabling fatigue, headache, widespread pain, fainting, gastrointestinal dysmotility, limb weakness, memory impairment episodes of altered awareness, and abnormal movements. This constellation of symptoms and signs has been labeled with different diagnoses such as complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), small fiber neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or fibromyalgia...
November 27, 2018: Immunologic Research
Robert D Fealey
Peripheral neuropathy affecting autonomic and small sensory fibers can cause abnormalities of both autonomic and behavioral thermoregulation. Quantitative autonomic and sensory neurophysiologic tests and quantification of the linear density of intraepidermal nerve fibers potentially can stratify those at risk of impaired thermoregulation during cold and heat challenges. New data relating to thermoregulatory sweating impairment in neuropathy are presented in this chapter. Of 516 neuropathy patients analyzed, 345 were found to have thermoregulatory sweat test (TST) abnormalities with a mean percentage of anterior body surface anhidrosis (TST%) of 12% and a significant reduction in total body sweat rate, although the rate of core temperature rise with heating (slope) was not significantly different from that of patients with a normal TST...
2018: Handbook of Clinical Neurology
Haruki Koike, Ryoji Nishi, Shohei Ikeda, Yuichi Kawagashira, Masahiro Iijima, Masahisa Katsuno, Gen Sobue
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a form of chronic neuropathy that is presumably caused by heterogeneous immune-mediated processes. Recent advances in the search for autoantibodies against components expressed at nodal regions, such as the nodes of Ranvier and paranodes, have substantially contributed to clarifying the pathogenesis of CIDP in a subpopulation of patients. In particular, immunoglobulin G4 (IgG4) antibodies to paranodal junction proteins, including neurofascin-155 and contactin-1, have attracted the attention of researchers...
December 4, 2018: Neurology
Maria Rotaru, Sanda Marchian, Gyula Laszlo Fekete, Gabriela Mariana Mariana Iancu
Dear Editor, Eczema is an inflammatory dermatitis mediated by cellular immunity, with an etiology in which environmental, immunological, and genetic factors are involved. Skin inflammation through proinflammatory cytokines creates a favorable environment for microbial antigens and optimal conditions for infection (1). In case of underlying immunosuppression, inflammatory features of dermatitis and superimposed infections are more severe. The presence of minor trauma of the skin in the form of fissures can favor both easier inoculation of some bacterial germs, leading to a dermatitis superinfection, and/or the transcutaneous inoculation of atypical mycobacteria, with a possibility of developing localized types of tuberculous lymphadenitis (TLA)...
October 2018: Acta Dermatovenerologica Croatica: ADC
Elisabetta Zucchi, Francesco Cavallieri, Giada Giovannini, Francesca Antonelli, Maria Teresa Mascia, Roberta Bedin, Jessica Mandrioli
A 64 years-old woman presented subacute onset distal paraesthesia concurrently with cold-induced urticaria, a rare form of physical urticaria. Both the disturbances developed a fortnight after an upper respiratory tract infection. EMG confirmed an exclusively sensory polyneuropathy, with prolongation of distal latencies and reduction of amplitudes. Anti-GQ1b and anti-GT1a antigangliosides antibodies were found in serum. The clinical workout included CSF analysis, cryoglobulin and paraprotein search, neurotropic infective agents, neoplastic markers and extensive autoimmune disease antibodies analysis, all of which resulted negative...
October 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Gary M Owens
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a symmetric demyelinating peripheral neuropathy with either a progressive or relapsing remitting course. CIDP is both debilitating and degenerative, leaving patients with functional impairment due to nerve damage in their extremities. Along with its medical burden, CIDP has a significant economic impact, with disease-related expenses and the often fairly high costs related to the immune therapies used to treat the disease. Costs for patients with this disorder often exceed those of other immune-mediated neuromuscular diseases...
September 2018: American Journal of Managed Care
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No abstract text is available yet for this article.
October 11, 2018: Nature Reviews. Disease Primers
Bernd C Kieseier, Emily K Mathey, Claudia Sommer, Hans-Peter Hartung
Since the discovery of an acute monophasic paralysis, later coined Guillain-Barré syndrome, almost 100 years ago, and the discovery of chronic, steroid-responsive polyneuropathy 50 years ago, the spectrum of immune-mediated polyneuropathies has broadened, with various subtypes continuing to be identified, including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN). In general, these disorders are speculated to be caused by autoimmunity to proteins located at the node of Ranvier or components of myelin of peripheral nerves, although disease-associated autoantibodies have not been identified for all disorders...
October 11, 2018: Nature Reviews. Disease Primers
Theresa Meldgaard, Søren Schou Olesen, Adam D Farmer, Klaus Krogh, Anne Astrid Wendel, Birgitte Brock, Asbjørn Mohr Drewes, Christina Brock
The incidence of the micro- and macrovascular complications of diabetes is rising, mirroring the increase in the worldwide prevalence. Arguably, the most common microvascular complication is neuropathy, leading to deleterious changes in both the structure and function of neurons. Amongst the various neuropathies with the highest symptom burden are those associated with alterations in the enteric nervous system, referred to as diabetic enteropathy. The primary aim of this review is to provide a contemporaneous summary of pathophysiology of diabetic enteropathy thereby allowing a "molecule to mechanism" approach to treatment, which will include 4 distinct aspects...
2018: Journal of Diabetes Research
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