Lotan I, Hellman M A, Steiner I
Department of Neurology, Rabin Medical Center, Beilinson Campus, PetachTikva; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Acta Neurol Scand. 2015 Oct;132(4):278-83. doi: 10.1111/ane.12394. Epub 2015 Mar 25.
The possibility of co-association between diabetes mellitus (DM) and chronic inflammatory demyelinating polyneuropathy (CIDP) has long been a focus of interest as well as of clinical significance. As CIDP is a potentially treatable condition, it is diagnosis in the context of DM is of great importance. However, diagnostic criteria to identify CIDP in patients with diabetes are not available. We propose a diagnostic tool that should help clinicians to decide what is the probability that a patient with diabetes might have CIDP.
We list several clinical, electrophysiological, and laboratory parameters that, when combined, have the power of discriminating an immune-mediated neuropathy in patients with DM. By summing the points assigned to each of these parameters, we define four levels of probability for a patient with diabetes to have CIDP. To analyze the validity of the diagnostic toll, we applied it in three different patient populations: (i) Patients with diabetes with peripheral neuropathy, (ii) Patients with CIDP without DM, and (iii) Patients with diabetes with CIDP.
The scores of patients with diabetes without CIDP ranged from -7 to 2, while those of patients with DM-CIDP ranged from 2 to 20. The scores of non-diabetic patients with CIDP were similar to those of patients with DM-CIDP and ranged from 6 to 16. The mean score of patients with DM-CIDP was 9.083, while the score of patients with CIDP was 11.16 and that of patients with diabetic polyneuropathy was -3.59.
These results show that this diagnostic tool is able to identify patients with diabetes with overlapping CIDP.
糖尿病（DM）与慢性炎症性脱髓鞘性多发性神经病（CIDP）共关联的可能性长期以来一直是人们关注的焦点，且具有临床意义。由于CIDP是一种潜在可治疗的疾病，因此在糖尿病背景下对其进行诊断至关重要。然而，目前尚无用于识别糖尿病患者中CIDP的诊断标准。我们提出一种诊断工具，应有助于临床医生判断糖尿病患者患CIDP的可能性有多大。
我们列出了几个临床、电生理和实验室参数，这些参数结合起来有能力区分糖尿病患者的免疫介导性神经病。通过对分配给每个参数的分数进行求和，我们为糖尿病患者患CIDP定义了四个概率水平。为了分析该诊断工具的有效性，我们将其应用于三个不同的患者群体：（i）患有周围神经病的糖尿病患者，（ii）无糖尿病的CIDP患者，以及（iii）患有CIDP的糖尿病患者。
无CIDP的糖尿病患者得分在 -7至2之间，而糖尿病合并CIDP患者的得分在2至20之间。非糖尿病的CIDP患者得分与糖尿病合并CIDP患者相似，在6至16之间。糖尿病合并CIDP患者的平均得分为9.083，CIDP患者的得分为11.16，糖尿病性多发性神经病患者的得分为 -3.59。
这些结果表明，该诊断工具能够识别患有重叠性CIDP的糖尿病患者。
