Attenzione: i dati modificati non sono ancora stati salvati. Per confermare inserimenti o cancellazioni di voci è necessario confermare con il tasto SALVA/INSERISCI in fondo alla pagina
Background and ObjectivesTo investigate CSF findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barre syndrome (GBS) based on 1,500 patients in the International GBS Outcome Study.MethodsAlbuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (<50 cells/& mu;L). We excluded 124 (8%) patients because of other diagnoses, protocol violation, or insufficient data. The CSF was examined in 1,231 patients (89%).ResultsIn 846 (70%) patients, CSF examination showed ACD, which increased with time from weakness onset: & LE;4 days 57%, >4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25-0.70; p = 0.001) and week 4 (OR 0.44, 95% CI 0.27-0.72; p = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was <5 cells/& mu;L in 1,005 patients (83%), 5-49 cells/& mu;L in 200 patients (16%), and & GE;50 cells/& mu;L in 13 patients (1%).DiscussionACD is a common finding in GBS, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely & GE;50 cells/& mu;L, is compatible with GBS after a thorough exclusion of alternative diagnoses.Classification of EvidenceThis study provides Class IV evidence that CSF ACD (defined by the Brighton Collaboration) is common in patients with GBS.
CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome
Al-Hakem, Helle;Doets, Alex Y.;Stino, Amro Maher;Zivkovic, Sasha A.;Andersen, Henning;Willison, Hugh J.;Cornblath, David R.;Gorson, Kenneth C.;Islam, Zhahirul;Mohammad, Quazi Deen;Sindrup, Søren Hein;Kusunoki, Susumu;Davidson, Amy;Casasnovas, Carlos;Bateman, Kathleen;Miller, James A. L.;van den Berg, Bianca;Verboon, Christine;Roodbol, Joyce;Leonhard, Sonja E.;Arends, Samuel;Luijten, Linda W. G.;Benedetti, Luana;Kuwabara, Satoshi;Van den Bergh, Peter;Monges, Soledad;Marfia, Girolama A.;Shahrizaila, Nortina;Galassi, Giuliana;Pereon, Yann;Bürmann, Jan;Kuitwaard, Krista;Kleyweg, Ruud P.;Marchesoni, Cintia;Sedano Tous, María J.;Querol, Luis;Martín-Aguilar, Lorena;Wang, Yuzhong;Nobile-Orazio, Eduardo;Rinaldi, Simon;Schenone, Angelo;Pardo, Julio;Vermeij, Frederique H.;Waheed, Waqar;Lehmann, Helmar C.;Granit, Volkan;Stein, Beth;Cavaletti, Guido;Gutiérrez-Gutiérrez, Gerardo;Barroso, Fabio A.;Visser, Leo H.;Katzberg, Hans D.;Dardiotis, Efthimios;Attarian, Shahram;van der Kooi, Anneke J.;Eftimov, Filip;Wirtz, Paul W.;Samijn, Johnny P. A.;Gilhuis, H. Jacobus;Hadden, Robert D. M.;Holt, James K. L.;Sheikh, Kazim A.;Kolb, Noah;Karafiath, Summer;Vytopil, Michal;Antonini, Giovanni;Feasby, Thomas E.;Faber, Catharina;Kramers, Hans;Busby, Mark;Roberts, Rhys C.;Silvestri, Nicholas J.;Fazio, Raffaella;van Dijk, Gert W.;Garssen, Marcel P. J.;Verschuuren, Jan;Harbo, Thomas;Jacobs, Bart C.;Hughes, R. A. C.;Hartung, H. P.;de Koning, L. C.;Mandarakas, M.;van Woerkom, M.;Reisin, R. C.;Reddel, S. W.;Hsieh, S. T.;Addington, J. M.;Ajroud-Driss, S.;Alessandro, L.;Badrising, U. A.;Balloy, G.;Bella, I. R.;Bertorini, T. E.;Bhavaraju-Sanka, R.;Bianco, M.;Brannagan, T. H.;Brennan, K.;Briani, C.;Butterworth, S.;Chao, C. C.;Chen, S.;Claeys, K. G.;Conti, M. E.;Cosgrove, J. S.;Dalakas, M. C.;Derejko, M.;Dimachkie, M. M.;Echaniz-Laguna, A.;Fokke, C.;Fujioka, T.;Fulgenzi, E. A.;Sobrino, T. García;Gijsbers, C. J.;Gilchrist, J. M.;Goldstein, J. M.;Goodfellow, J.;Goyal, N. A.;Grisanti, S.;Gutmann, L.;Htut, M.;Jellema, K.;Pascual, I. Jericó;Jimeno-Montero, M. C.;Kaida, K.;Kerkhoff, H.;Khoshnoodi, M.;Kiers, L.;Kuwahara, M.;Kwan, J. Y.;Ladha, S. S.;Lassen, L. Landschoff;Lawson, V.;Pan, E. Lee;Lunn, M. P. T.;Manji, H.;Infante, C. Márquez;Hernandez, E. Martinez;Mataluni, G.;Mattiazzi, M. G.;McDermott, C. J.;Meekins, G. D.;Morís de la Tassa, G.;Nascimbene, C.;Nowak, R. J.;Orizaola, P.;Osei-Bonsu, M.;Pardal, A.;Pascual-Goñi, E.;Pascuzzi, R. M.;Prada, V.;Pulley, M.;Rojas-Marcos, I.;Rudnicki, S. A.;Sachs, G. M.;Santoro, L.;Savransky, A.;Schwindling, L.;Sekiguchi, Y.;Sommer, C. L.;Tan, C-Y;Tankisi, H.;Twydell, P. T.;van Damme, P.;van der Ree, T.;van Koningsveld, R.;Varrato, J. D.;Santamaria, V. Vélez;Walgaard, C.;Yamagishi, Y.;Zhang, L.;MM, null;Zhou, L.;null, null
2023
Abstract
Background and ObjectivesTo investigate CSF findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barre syndrome (GBS) based on 1,500 patients in the International GBS Outcome Study.MethodsAlbuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (<50 cells/& mu;L). We excluded 124 (8%) patients because of other diagnoses, protocol violation, or insufficient data. The CSF was examined in 1,231 patients (89%).ResultsIn 846 (70%) patients, CSF examination showed ACD, which increased with time from weakness onset: & LE;4 days 57%, >4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25-0.70; p = 0.001) and week 4 (OR 0.44, 95% CI 0.27-0.72; p = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was <5 cells/& mu;L in 1,005 patients (83%), 5-49 cells/& mu;L in 200 patients (16%), and & GE;50 cells/& mu;L in 13 patients (1%).DiscussionACD is a common finding in GBS, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely & GE;50 cells/& mu;L, is compatible with GBS after a thorough exclusion of alternative diagnoses.Classification of EvidenceThis study provides Class IV evidence that CSF ACD (defined by the Brighton Collaboration) is common in patients with GBS.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3510428
Citazioni
2
3
4
social impact
Conferma cancellazione
Sei sicuro che questo prodotto debba essere cancellato?
simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.