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Idiopathic inflammatory polyradiculoneuropathy: Evaluation of clinical and laboratory data and therapeutic considerations

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Abstract

The clinical, immunological and neurophysiological data on 54 patients with idiopathic inflammatory polyradiculoneuropathy (IIP) are reviewed in order to reach a correct diagnostic and therapeutic approach. 49 of these patients presented acute and 5 recurrent IIP. Of the acute cases 10 patients had a severe course with paralysis of all limbs and respiratory insufficiency, and 3 died. An increase in CSF total proteins and impairment of nerve motor conduction velocities proved to be valuable tests for the diagnosis of IIP; these tests usually become more significant after 2 or 3 weeks of illness. Steroid treatment did not prove to be effective, while two patients with acute and progressive IIP, subjected to plasmapheresis, showed rapid and steady improvement. In these two patients the plasmapheresis was associated with azathioprine.

Sommario

I dati clinici, immunologici e neurofisiologici di 54 pazienti affetti da poliradicolneuropatia idiopatica infiammatoria (IIP) sono stati rivalutati con lo scopo di definire un corretto approccio diagnostico e terapeutico. 49 pazienti presentavano una forma acuta dell'affezione, mentre 5 una forma ricorrente. Nei cast acuti, 10 soggetti hanno mostrato un andamento grave con tetraplegia ed insufficienza respiratoria: 3 pazienti sono deceduti. L'incremento delle proteine totali nel liquor e la riduzione della velocità di conduzione motoria sono risultati validi test per la diagnosi di IIP;questi test erano maggiormente significativi dopo 2 o 3 settimane di malattia. Il trattamento steroideo non è risultato efficace, mentre 2 pazienti con una forma acuta e progressiva di IIP hanno mostrato un immediato miglioramento dopo plasmaferesi. In questi 2 casi la plasmaferesi era associata ad azatioprina.

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Authors and Affiliations

  1. Clinica Neurologica II, Università di Milano, Italia

    Valli G., Ferini Strambi L., Nobile Orazio E. & Scarlato G.

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  1. Valli G.
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  2. Ferini Strambi L.
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  4. Scarlato G.
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Valli, G., Ferini Strambi, L., Nobile Orazio, E. et al. Idiopathic inflammatory polyradiculoneuropathy: Evaluation of clinical and laboratory data and therapeutic considerations. Ital J Neuro Sci 4, 19–26 (1983). https://doi.org/10.1007/BF02043433

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