Towards a standardised analysis of CSF in inflammatory neuropathies

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 been previously reported in inflammatory neuropathies.

In particular, transient CSF-restricted OCBs have been observed in Guillain-Barré syndrome…

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