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  1. Article ; Online: Autonomic nervous system involvement in chronic inflammatory demyelinating polyradiculoneuropathy: a literature review.

    Rzepiński, Łukasz / Doneddu, Pietro Emiliano / Cutellè, Claudia / Zawadka-Kunikowska, Monika / Nobile-Orazio, Eduardo

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2023  Volume 44, Issue 9, Page(s) 3071–3082

    Abstract: ... may indicate the presence of a comorbid disease (e.g., diabetes) and facilitate the differentiation of CIDP ... from other neuropathies (e.g., amyloid neuropathy). Five studies performed quantitative assessment of autonomic function ...

    Abstract Background and aims: Although dysautonomia is a well-recognized complication of acute demyelinating polyradiculoneuropathy, it is rarely reported and evaluated in chronic demyelinating neuropathies. The purpose of this review is to search and synthesize the current literature on the prevalence and type of autonomic dysfunction (AD) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
    Methods: PubMed and Web of Science were searched for studies reporting AD in CIDP.
    Results: Twelve studies, including 346 patients with CIDP, were found eligible for the review. Seven studies used autonomic tests only as an additional component of the comprehensive clinical evaluation, and found that dysautonomia in CIDP may indicate the presence of a comorbid disease (e.g., diabetes) and facilitate the differentiation of CIDP from other neuropathies (e.g., amyloid neuropathy). Five studies performed quantitative assessment of autonomic function in CIDP as a primary goal. Two studies have used the Composite Autonomic Severity Score (CASS) to assess severity and distribution of dysautonomia. The reported prevalence of dysautonomia in CIDP during quantitative assessment of autonomic function ranged from 25 to 89%, depending on the battery of tests used, with CASS not exceeding 4 points. The abnormalities in autonomic tests indicated both sympathetic and parasympathetic dysfunction and did not correlate with the duration, severity and variant of CIDP.
    Conclusions: Clinical or subclinical involvement of the ANS has been shown to be common and relatively mild in CIDP. The impact of autonomic impairment on disability and of its possible response to therapy in CIDP needs to be further investigated.
    MeSH term(s) Humans ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/complications ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/diagnosis ; Autonomic Nervous System ; Diabetes Mellitus ; Primary Dysautonomias/diagnosis ; Primary Dysautonomias/epidemiology ; Primary Dysautonomias/etiology
    Chemical Substances 6-chloropenicillanic acid S-sulfoxide (97729-66-3)
    Language English
    Publishing date 2023-04-21
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-023-06802-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Daily grip strength response to intravenous immunoglobulin in chronic immune neuropathies.

    Doneddu, Pietro E / Hadden, Robert D M

    Muscle & nerve

    2020  Volume 62, Issue 1, Page(s) 103–110

    Abstract: Introduction: Monitoring grip strength at home may detect improvement between intravenous immunoglobulin (IVIg) treatments in patients with chronic inflammatory neuropathies (CINs).: Methods: Fifteen patients recorded grip strength each day, from one ...

    Abstract Introduction: Monitoring grip strength at home may detect improvement between intravenous immunoglobulin (IVIg) treatments in patients with chronic inflammatory neuropathies (CINs).
    Methods: Fifteen patients recorded grip strength each day, from one IVIg treatment until the next. We analyzed grip strength changes comparing thresholds of 8 kPa and 14 kPa. "Random" fluctuations of grip strength were distinguished from treatment response by smoothing the data.
    Results: "Random" fluctuations of at least 8 kPa occurred in 27% of patients. Smoothed daily grip strength increased by at least 8 kPa above baseline in 11 (73%) patients. Grip strength increased by at least 8 kPa for 3 consecutive days in 9 (60%) patients, and 5-day block mean increased by at least 8 kPa in 10 (67%) patients.
    Discussion: Home monitoring of grip strength confirmed treatment response in most patients with CINs on IVIg. To detect improvement in an individual patient, we suggest a threshold of at least 8 kPa on 3 consecutive days or on 5-day block mean.
    MeSH term(s) Adult ; Aged ; Female ; Hand Strength/physiology ; Home Care Services/standards ; Home Care Services/trends ; Humans ; Immunoglobulins, Intravenous/administration & dosage ; Male ; Middle Aged ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/diagnosis ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/drug therapy ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/physiopathology ; Self Report/standards
    Chemical Substances Immunoglobulins, Intravenous
    Language English
    Publishing date 2020-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 438353-9
    ISSN 1097-4598 ; 0148-639X
    ISSN (online) 1097-4598
    ISSN 0148-639X
    DOI 10.1002/mus.26898
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Acute and chronic inflammatory neuropathies and COVID-19 vaccines: Practical recommendations from the task force of the Italian Peripheral Nervous System Association (ASNP).

    Doneddu, Pietro E / Spina, Emanuele / Briani, Chiara / Fabrizi, Gian Maria / Manganelli, Fiore / Nobile-Orazio, Eduardo

    Journal of the peripheral nervous system : JPNS

    2021  Volume 26, Issue 2, Page(s) 148–154

    Abstract: Background and aims: To develop recommendations for vaccination for coronavirus-19 (COVID-19) in patients with inflammatory neuropathies.: Methods: Key questions were formulated in order to perform a literature review on the safety and efficacy of ... ...

    Abstract Background and aims: To develop recommendations for vaccination for coronavirus-19 (COVID-19) in patients with inflammatory neuropathies.
    Methods: Key questions were formulated in order to perform a literature review on the safety and efficacy of vaccines in patients with inflammatory neuropathies. Based on the best evidence and expert opinion, a list of recommendations was formulated to inform decision on vaccination for COVID-19 in patients with inflammatory neuropathies and increase adherence to vaccination programmes.
    Results: Recommendations addressing safety and efficacy of vaccination in patients with inflammatory neuropathies were formulated. No data are currently available on the safety and efficacy of COVID-19 vaccines in patients with inflammatory neuropathies or other immune-mediated conditions. There is only sparse data on the safety of previous available vaccines in patients with inflammatory neuropathies, but studies on other autoimmune disorders indicate that these are safe and mostly efficacious. Patients with inflammatory neuropathies might be at increased risk for severe illness from COVID-19.
    Interpretation: Patients with inflammatory neuropathies should be encouraged to adhere to the vaccination campaign for COVID-19. These recommendations provide guidance on the management of vaccinations for COVID-19 in patients with inflammatory neuropathies. More research is needed regarding the safety and efficacy of vaccination in patients with inflammatory neuropathies and other immune conditions.
    MeSH term(s) COVID-19 Vaccines/adverse effects ; COVID-19 Vaccines/therapeutic use ; Guillain-Barre Syndrome ; Humans ; Italy ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; Practice Guidelines as Topic/standards ; Societies, Medical/standards ; Vaccination/standards
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-03-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1364009-4
    ISSN 1529-8027 ; 1085-9489
    ISSN (online) 1529-8027
    ISSN 1085-9489
    DOI 10.1111/jns.12435
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Atypical chronic inflammatory demyelinating polyradiculoneuropathy: recent advances on classification, diagnosis, and pathogenesis.

    Doneddu, Pietro Emiliano / Dentoni, Marta / Nobile-Orazio, Eduardo

    Current opinion in neurology

    2021  Volume 34, Issue 5, Page(s) 613–624

    Abstract: Purpose of review: In recent years, there has been an intense debate in literature regarding the definition of the individual variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), their possible pathogenetic mechanisms, and ... ...

    Abstract Purpose of review: In recent years, there has been an intense debate in literature regarding the definition of the individual variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), their possible pathogenetic mechanisms, and impact in the diagnosis of CIDP.
    Recent findings: The 2021 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) guidelines revised the definition of the individual CIDP variants and implemented their diagnostic criteria. Diagnosis of atypical CIDP is challenging and misdiagnosis is frequent, leading to diagnostic delay and consequent greater accumulation of disability and treatment dependency. Recent studies suggest that patients with typical CIDP have an antibody-mediated mechanism of neuropathy whereas in those with Lewis--Sumner syndrome (LSS) neuropathy is preferentially mediated by macrophages and T cells.
    Summary: Although the validity of the 2021 EFNS/PNS diagnostic criteria for atypical CIDP is unknown, they will hopefully lead to greater uniformity in the selection of patients to be enrolled in future studies and to a greater diagnostic accuracy. New data are emerging on the possible pathological mechanisms of individual variants and this could result in the discovery of specific diagnostic biomarkers and new therapies.
    MeSH term(s) Delayed Diagnosis ; Diagnostic Errors ; Humans ; Peripheral Nerves ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/diagnosis ; Retrospective Studies
    Language English
    Publishing date 2021-07-19
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1182686-1
    ISSN 1473-6551 ; 1350-7540
    ISSN (online) 1473-6551
    ISSN 1350-7540
    DOI 10.1097/WCO.0000000000000979
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Management of chronic inflammatory demyelinating polyradiculopathy.

    Doneddu, Pietro E / Nobile-Orazio, Eduardo

    Current opinion in neurology

    2018  Volume 31, Issue 5, Page(s) 511–516

    Abstract: Purpose of review: To review the recent advances in the management and treatment of chronic inflammatory demyelinating polyradiculopathy (CIDP).: Recent findings: Recent studies confirm the efficacy/safety of long-term intravenous immunoglobulin ( ... ...

    Abstract Purpose of review: To review the recent advances in the management and treatment of chronic inflammatory demyelinating polyradiculopathy (CIDP).
    Recent findings: Recent studies confirm the efficacy/safety of long-term intravenous immunoglobulin (IVIg) and short-term subcutaneous immunoglobulin (SCIg) therapy in CIDP. New outcome measures have been recently proposed and further studies evaluated the properties of those already in use. The presence of antibodies against proteins at the node of Ranvier was associated with specific clinical features and treatment response. Fingolimod adds to the list of immunosuppressive agents that failed to be effective in a controlled trial.
    Summary: Several studies evaluating the best strategy to provide maintenance IVIg treatment in CIDP are in progress. SCIg were shown to be an alternative to IVIg for maintenance treatment while their efficacy as initial therapy should be further addressed. New outcome measures have been shown to be effective in detecting treatment response in clinical trials, but their use in clinical practice remains uncertain. Similarly unsettled is the role of nerve imaging techniques as biomarker in CIDP. The discovery of antibodies against proteins at the node of Ranvier has rekindled a keen interest in the pathogenesis of CIDP and the potential therapeutic role of new agents.
    MeSH term(s) Fingolimod Hydrochloride/therapeutic use ; Humans ; Immunization, Passive ; Immunoglobulins, Intravenous/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/therapy ; Treatment Failure ; Treatment Outcome
    Chemical Substances Immunoglobulins, Intravenous ; Immunosuppressive Agents ; Fingolimod Hydrochloride (G926EC510T)
    Language English
    Publishing date 2018-04-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1182686-1
    ISSN 1473-6551 ; 1350-7540
    ISSN (online) 1473-6551
    ISSN 1350-7540
    DOI 10.1097/WCO.0000000000000595
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Neuropathic Pain in the Emergency Setting: Diagnosis and Management.

    Doneddu, Pietro Emiliano / Pensato, Umberto / Iorfida, Alessandra / Alberti, Claudia / Nobile-Orazio, Eduardo / Fabbri, Andrea / Voza, Antonio

    Journal of clinical medicine

    2023  Volume 12, Issue 18

    Abstract: Neuropathic pain, traditionally considered a chronic condition, is increasingly encountered in the emergency department (ED), accounting for approximately 20% of patients presenting with pain. Understanding the physiology and key clinical presentations ... ...

    Abstract Neuropathic pain, traditionally considered a chronic condition, is increasingly encountered in the emergency department (ED), accounting for approximately 20% of patients presenting with pain. Understanding the physiology and key clinical presentations of neuropathic pain is crucial for ED physicians to provide optimal treatment. While diagnosing neuropathic pain can be challenging, emphasis should be placed on obtaining a comprehensive medical history and conducting a thorough clinical examination. Patients often describe neuropathic pain as a burning or shock-like sensation, leading them to seek care in the ED after ineffective relief from common analgesics such as paracetamol and NSAIDs. Collaboration between emergency medicine specialists, neurologists, and pain management experts can contribute to the development of evidence-based guidelines specifically tailored for the emergency department setting. This article provides a concise overview of the common clinical manifestations of neuropathic pain that may prompt patients to seek emergency care.
    Language English
    Publishing date 2023-09-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12186028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: A diagnostic score for anti-myelin-associated-glycoprotein neuropathy or chronic inflammatory demyelinating polyradiculoneuropathy in patients with anti-myelin-associated-glycoprotein antibody.

    Doneddu, Pietro E / Ruiz, Marta / Bianchi, Elisa / Liberatore, Giuseppe / Manganelli, Fiore / Cocito, Dario / Cosentino, Giuseppe / Benedetti, Luana / Marfia, Girola A / Filosto, Massimiliano / Briani, Chiara / Giannotta, Claudia / Nobile-Orazio, Eduardo

    European journal of neurology

    2022  Volume 30, Issue 2, Page(s) 501–510

    Abstract: Background and purpose: A diagnostic score was developed to discriminate anti-myelin-associated-glycoprotein (MAG) neuropathy from chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and applied it to patients with atypical anti-MAG ... ...

    Abstract Background and purpose: A diagnostic score was developed to discriminate anti-myelin-associated-glycoprotein (MAG) neuropathy from chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and applied it to patients with atypical anti-MAG neuropathy.
    Methods: The clinical and electrophysiological features of patients with a diagnosis of typical anti-MAG neuropathy were compared to those of patients with a diagnosis of CIDP. The association of each feature with the diagnosis was assessed in the two groups. Features showing a significant association with the diagnosis were included in a multivariable logistic regression model and adjusted odds ratios were estimated for each feature. A score ranging from 1 to 3 was applied to each feature based on the magnitude of the estimated odds ratios. The score was then applied to patients with a clinical diagnosis of CIDP who also had high anti-MAG antibody titers (CIDP-MAG).
    Results: Thirty-one anti-MAG neuropathy patients, 45 typical CIDP patients and 16 CIDP-MAG patients were included. Scores in anti-MAG antibody patients ranged from 1 to 5 and in CIDP patients from -7 to -1. Using the score, 4/16 CIDP-MAG patients were diagnosed to have anti-MAG neuropathy and 12/16 patients to have CIDP. Response to intravenous immunoglobulin in the CIDP-MAG patients classified as CIDP was similar to that of definite CIDP patients and higher than that of anti-MAG neuropathy patients.
    Conclusions: Our score allowed an accurate discrimination to be made, amongst patients with anti-MAG antibodies, of those affected by CIDP and the patients with anti-MAG neuropathy. This score may help proper treatment to be chosen for patients with anti-MAG antibodies with a CIDP-like presentation.
    MeSH term(s) Humans ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/therapy ; Immunoglobulin M ; Immunoglobulins, Intravenous/therapeutic use ; Autoantibodies ; Myelin-Associated Glycoprotein ; Polyradiculoneuropathy/drug therapy
    Chemical Substances Immunoglobulin M ; Immunoglobulins, Intravenous ; Autoantibodies ; Myelin-Associated Glycoprotein
    Language English
    Publishing date 2022-03-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1280785-0
    ISSN 1468-1331 ; 1351-5101 ; 1471-0552
    ISSN (online) 1468-1331
    ISSN 1351-5101 ; 1471-0552
    DOI 10.1111/ene.15296
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Cytokines and chemokines in patients with chronic inflammatory demyelinating polyradiculoneuropathy and multifocal motor neuropathy: A systematic review.

    Cutellè, Claudia / De Lorenzo, Alberto / Doneddu, Pietro Emiliano / Creta, Maria Francesca / Selmi, Carlo / Liberatore, Giuseppe / Giordano, Andrea / Gentile, Francesco / Erre, Gian Luca / Nobile-Orazio, Eduardo

    Journal of the peripheral nervous system : JPNS

    2024  

    Abstract: Advances in the understanding of cytokines have revolutionized mechanistic treatments for chronic inflammatory and autoimmune diseases, as exemplified by rheumatoid arthritis. We conducted a systematic literature review on the role of cytokines and ... ...

    Abstract Advances in the understanding of cytokines have revolutionized mechanistic treatments for chronic inflammatory and autoimmune diseases, as exemplified by rheumatoid arthritis. We conducted a systematic literature review on the role of cytokines and chemokines in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN). Ovid Medline, EMBASE and Web of Science were searched until August 31, 2022 for human studies investigating cytokines levels in CIDP or MMN. Fifty-five articles on 1061 CIDP patients and 86 MMN patients were included, with a median of 18 patients per study (range 3-71). Studies differed in the inclusion criteria, type of assay, manufacturer, control subjects, and tested biological material. Only a minority of studies reported data on disease activity. Interleukin (IL)-6, IL-17, CXCL10, and tumor necrosis factor alpha (TNF-α), were elevated in CIDP compared to controls in most of the studies. IL-6 and TNF-α levels are also correlated with disability. In MMN patients, IL-1Ra was elevated in the majority of the reports. While acknowledging the challenges in comparing studies and the various limitations of the studies, including small patient numbers, particularly in MMN, our review suggests that IL-6, IL-17, CXCL10, and TNF-α might play a role in CIDP pathogenesis. Larger studies are needed in MMN.
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1364009-4
    ISSN 1529-8027 ; 1085-9489
    ISSN (online) 1529-8027
    ISSN 1085-9489
    DOI 10.1111/jns.12622
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  9. Article ; Online: Neuralgic amyotrophy mimicking Vernet syndrome.

    Doneddu, Pietro E / Sechi, Elia / Addis, Alberto / Fadda, Giulia / Fois, Chiara / Sechi, GianPietro

    Journal of the neurological sciences

    2016  Volume 362, Page(s) 230–231

    MeSH term(s) Aged ; Brachial Plexus Neuritis/diagnosis ; Humans ; Laryngoscopy ; Male ; Neurologic Examination ; Vipoma/physiopathology
    Language English
    Publishing date 2016-03-15
    Publishing country Netherlands
    Document type Case Reports ; Letter
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2016.01.064
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Update on therapy of chronic immune-mediated neuropathies.

    Briani, Chiara / Cocito, Dario / Campagnolo, Marta / Doneddu, Pietro Emiliano / Nobile-Orazio, Eduardo

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2021  

    Abstract: Chronic immune-mediated neuropathies, including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), neuropathies associated with monoclonal gammopathy, and multifocal motor neuropathy (MMN), are a group of disorders deemed to be caused by ... ...

    Abstract Chronic immune-mediated neuropathies, including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), neuropathies associated with monoclonal gammopathy, and multifocal motor neuropathy (MMN), are a group of disorders deemed to be caused by an immune response against peripheral nerve antigens. Several immune therapies have been reported to be variably effective in these neuropathies including steroids, plasma exchange, and high-dose intravenous (IVIg) or subcutaneous (SCIg) immunoglobulins. These therapies are however far from being invariably effective and may be associated with a number of side effects leading to the use of immunosuppressive agents whose efficacy has not been so far confirmed in randomized trials. More recently, new biological agents, such as rituximab, have proved to be effective in patients with neuropathy associated with IgM monoclonal gammopathy and are currently tested in CIDP.
    Language English
    Publishing date 2021-01-16
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-020-04998-y
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