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No evidence of cerebrospinal fluid-restricted humoral response in chronic inflammatory demyelinating polyneuropathy
The diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) typically relies on clinical and electrodiagnostic findings. A spinal tap and cerebrospinal fluid (CSF) analysis are sometimes performed, and an increased protein level in the CSF can be used as supportive diagnostic criteria.
However, the identification of increased CSF proteins with normal cell count, also referred to as albuminocytological dissociation, is not specific to CIDP and can be observed in other inflammatory and non-inflammatory conditions affecting the central nervous system and/or peripheral nervous system (PNS), as well during ageing, so that its interpretation in a patient with peripheral neuropathy is cumbersome.
Moreover, unique-to-CSF oligoclonal bands (OCBs) of IgG, which represent the hallmark of a CSF-restricted neuroinflammation with intrathecal antibody production as seen in multiple sclerosis, have …
Contributors AC, MG and EV analysed the data and contributed to drafting and revising the manuscript.
Funding AC thanks the Medical Research Council (MR/T001712/1), the Fondazione CARIPLO (2019-1836), the Italian Ministry of Health Ricerca Corrente 2018–2019, the Inherited Neuropathy Consortium (INC) and Fondazione Regionale per la Ricerca Biomedica for grant support.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.