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Alterations of the Cerebrospinal Fluid in Chronic Inflammatory Diseases of the Peripheral Nervous System

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Cerebrospinal Fluid in Clinical Neurology

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Abstract

Chronic inflammatory neuropathies comprise a heterogeneous group of diseases mainly characterized by a demyelinating pathology. The most common disease, CIDP (chronic inflammatory demyelinating polyneuropathy), can be further categorized based on the clinical symptoms and associated diseases. Three other syndromes have been well defined. Similar to CIDP, distal acquired demyelinating sensory polyneuropathy (DADS) evolves with symmetrical symptoms. In contrast, multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor neuropathy (MADSAM, Lewis-Sumner syndrome) are asymmetric polyneuropathies. In this chapter, we discuss CSF alterations in these four main syndromes of demyelinating chronic inflammatory neuropathies, the chronic neuropathies associated with M proteins, and the vasculitic neuropathies. Although we touch some of the hematological malignancies associated with paraproteinemic polyneuropathies, paraneoplastic neurological diseases of the PNS are described in a separate chapter. Altogether, increased protein in the CSF is a supportive factor of CIDP, especially when electrophysiological criteria are not definite. A number of specific markers have been also investigated in the CSF of patients with chronic inflammatory neuropathies, but their role in differentiating the different syndromes, supporting diagnosis of MMN, or predicting the clinical course and treatment responses is inconclusive.

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Abbreviations

ANCA:

Anti-neutrophil cytoplasmic antibody

CRP:

C-reactive protein

EFNS:

European Federation of Neurological Societies

ESR:

Erythrocyte sedimentation rate

FGF:

Fibroblast growth factor

G-CSF:

Granulocyte colony-stimulating factor

GM-CSF:

Granulocyte macrophage colony-stimulating factor

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

ICAM-1:

Intercellular adhesion molecule 1

IFN:

Interferon

IL:

Interleukin

LIF:

Leukemia inhibitory factor

M-CSF:

Macrophage colony-stimulating factor

MIF:

Macrophage migration inhibitory factor

MPA:

Microscopic polyangiitis

PAN:

Polyarteritis nodosa

PDGFbb:

Platelet-derived growth factor-BB

SCGF-β:

Stem cell growth factor beta

Th:

T helper

TNF:

Tumor necrosis factor

TRAIL:

Tumor necrosis factor-related apoptosis-inducing ligand

VCAM-1:

Vascular cell adhesion molecule 1

VEGF:

Vascular endothelial growth factor

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Authors and Affiliations

  1. Department of Neurology, Odense University Hospital, Sdr. Boulevard 29, Odense, 5000, Denmark

    Zsolt Illes & Morten Blaabjerg

  2. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Zsolt Illes

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  1. Zsolt Illes
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  2. Morten Blaabjerg
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Correspondence to Zsolt Illes .

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Editors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

    Florian Deisenhammer

  2. Department of Neurology, Danish Multiple Sclerosis Center Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Finn Sellebjerg

  3. Department of Clinical Chemistry, VU University Medical Center Amsterdam Neurochemistry Laboratory and Biobank, Amsterdam, The Netherlands

    Charlotte E Teunissen

  4. Department of Neurology, University of Ulm, Ulm, Germany

    Hayrettin Tumani

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Illes, Z., Blaabjerg, M. (2015). Alterations of the Cerebrospinal Fluid in Chronic Inflammatory Diseases of the Peripheral Nervous System. In: Deisenhammer, F., Sellebjerg, F., Teunissen, C., Tumani, H. (eds) Cerebrospinal Fluid in Clinical Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-01225-4_19

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