RT Journal Article
SR Electronic
T1 Application of the 2021 EAN/PNS criteria for chronic inflammatory demyelinating polyneuropathy
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1247
OP 1252
DO 10.1136/jnnp-2022-329633
VO 93
IS 12
A1 Yusuf A Rajabally
A1 Saadia Afzal
A1 Lay Khoon Loo
A1 HS Goedee
YR 2022
UL http://jnnp.bmj.com/content/93/12/1247.abstract
AB Background The diagnostic value of new criteria of the European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) for chronic inflammatory demyelinating polyneuropathy (CIDP) is unknown.Methods We performed a retrospective study of fulfilment of EAN/PNS 2021 criteria on 120 consecutive patients with a clinical diagnosis of ‘suspected CIDP’ and objective treatment response, attending University Hospitals Birmingham, UK. Specificity was evaluated versus 100 consecutive controls.Results The sensitivity of EAN/PNS criteria for ‘CIDP’ was 83.3%. The sensitivity for ‘CIDP’ or ‘possible CIDP’ was 93.3%. Specificity was of 94% for ‘CIDP’ and 79% for ‘CIDP’ or ‘possible CIDP’. No sensitivity/specificity differences were ascertained with previous versions (‘CIDP’: sensitivity: 83.3% vs 81.3%, p=0.74, specificity: 94% vs 96.1%, p=0.38, respectively; ‘CIDP’ or ‘possible CIDP’: sensitivity: 93.3% vs 96.7%, p=0.25 and specificity: 79% vs 69.2 %, p=0.09, respectively). F-wave prolongation, proximal and distal temporal dispersion were the most likely parameters to contribute to false positives, whereas distal motor latency was the least likely. No impact of sensory electrophysiology could be ascertained. ‘Typical CIDP’ represented 79% of the CIDP cohort. The largest component of the ‘variant CIDP’ group was represented by focal/multifocal forms (14%). With new criteria, 6.7% of the cohort did not meet requirements, among whom the majority (75%) had paranodopathy or chronic immune sensory polyradiculopathy (CISP).Discussion The sensitivity and specificity of new EAN/PNS criteria for CIDP is equivalent to that of previous versions. The exclusion of paranodopathies and CISP from the CIDP spectrum impacts on management of a non-negligible proportion of treatment-responsive patients.Data are available on reasonable request. Available on reasonable request.