Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Department of Otolaryngology, Hannover Medical School, Hannover, Germany.
J Neurol. 2021 Aug;268(8):2908-2912. doi: 10.1007/s00415-021-10459-z. Epub 2021 Feb 21.
This study addresses the challenging characterisation and differentiation of CIDP versus CIDP in association with Sjögren's syndrome to facilitate the process in clinical routine.
Patients with both CIDP and Sjögren's syndrome and CIDP without Sjögren's syndrome were compared concerning relevant differences in clinical, laboratory and electrophysiological findings. 154 patients who fulfilled the diagnostic EFNS/PNS criteria for CIDP were included in the analysis. 54 of these patients additionally fulfilled the ACR/EULAR classification criteria for Sjögren's syndrome.
The frequency of female patients was higher in patients with CIDP and Sjögren's syndrome (52%) versus CIDP patients without Sjögren's syndrome (28%). Furthermore, the occurrence of cranial nerve impairment was significantly higher in patients with Sjögren's syndrome (39% versus 14%). There were no significant group differences in the evaluation of initial symptoms, severity of disability judged by INCAT disability scale score, presence or distribution of sensory deficits, limb weakness and the presence of ataxia, pain or dysautonomia, CSF laboratory or electrophysiological findings.
In conclusion, our data indicate that cranial nerve impairment and female gender might represent red flags for an additional Sjögren's syndrome in patients with CIDP. The patterns of clinical disabilities and electrophysiological findings due to peripheral nerve damage are similar in both CIDP entities.
本研究旨在对 CIDP 与合并干燥综合征的 CIDP 进行具有挑战性的特征描述和区分,以促进临床常规中的这一过程。
比较了同时患有 CIDP 和干燥综合征以及单纯 CIDP 患者的临床、实验室和电生理发现中的相关差异。纳入了符合 CIDP 的 EFNS/PNS 诊断标准的 154 例患者。其中 54 例患者还符合 ACR/EULAR 干燥综合征分类标准。
CIDP 合并干燥综合征患者(52%)中女性患者的频率高于单纯 CIDP 患者(28%)。此外,干燥综合征患者颅神经损伤的发生率明显更高(39% 对 14%)。在初始症状评估、根据 INCAT 残疾量表评分判断的残疾严重程度、感觉缺失的存在或分布、肢体无力和共济失调、疼痛或自主神经功能障碍、CSF 实验室或电生理发现方面,两组间无显著差异。
总之,我们的数据表明,颅神经损伤和女性性别可能是 CIDP 患者合并干燥综合征的标志。由于周围神经损伤引起的临床残疾和电生理发现模式在两种 CIDP 实体中相似。