Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Key Lab of Modern Toxicology, Ministry of Education, and Department of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
Eur J Neurol. 2024 May;31(5):e16222. doi: 10.1111/ene.16222. Epub 2024 Feb 14.
Clinical symptoms and laboratory indices for acute inflammatory demyelinating polyneuropathy (AIDP), a variant of Guillain-Barré syndrome, and acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) were analyzed to identify factors that could contribute to early differential diagnosis.
A retrospective chart review was performed on 44 AIDP and 44 A-CIDP patients looking for any demographic characteristics, clinical manifestations or laboratory parameters that might differentiate AIDP from acutely presenting CIDP.
In Guillain-Barré syndrome patients (N = 63), 69.84% (N = 44) were classified as having AIDP, 19.05% (N = 12) were found to have acute motor axonal neuropathy, 6.35% (N = 4) were found to have acute motor and sensory axonal neuropathy, and 4.76% (N = 3) were found to have Miller Fisher syndrome. Serum uric acid (UA) was higher in A-CIDP patients (329.55 ± 72.23 μmol/L) than in AIDP patients (221.08 ± 71.32 μmol/L) (p = 0.000). Receiver operating characteristic analyses indicated that the optimal UA cutoff was 283.50 μmol/L. Above this level, patients were more likely to present A-CIDP than AIDP (specificity 81.80%, sensitivity 81.80%). During the follow-up process, serum samples were effectively collected from 19 AIDP patients during the rehabilitation phase and 28 A-CIDP patients during the remission stage, and it was found that UA levels were significantly increased in A-CIDP (remission) (298.9 ± 90.39 μmol/L) compared with AIDP (rehabilitation) (220.1 ± 108.2 μmol/L, p = 0.009).
These results suggest that serum UA level can help to differentiate AIDP from A-CIDP with high specificity and sensitivity, which is helpful for early diagnosis and guidance of treatment.
对急性炎症性脱髓鞘性多发性神经病（AIDP），即格林-巴利综合征的一种变异型，和急性起病的慢性炎症性脱髓鞘性多发性神经病（A-CIDP）的临床症状和实验室指标进行分析，以确定有助于早期鉴别诊断的因素。
对 44 例 AIDP 和 44 例 A-CIDP 患者进行回顾性图表审查，寻找可能使 AIDP 与急性 CIDP 相区别的任何人口统计学特征、临床表现或实验室参数。
在格林-巴利综合征患者（N=63）中，69.84%（N=44）被归类为 AIDP，19.05%（N=12）为急性运动轴索性神经病，6.35%（N=4）为急性运动感觉轴索性神经病，4.76%（N=3）为米勒费舍尔综合征。A-CIDP 患者的血清尿酸（UA）水平高于 AIDP 患者（329.55±72.23μmol/L）（p=0.000）。受试者工作特征分析表明，UA 的最佳截断值为 283.50μmol/L。高于该水平时，患者更有可能表现为 A-CIDP 而不是 AIDP（特异性 81.80%，敏感性 81.80%）。在随访过程中，从 19 例 AIDP 患者的康复期和 28 例 A-CIDP 患者的缓解期有效收集了血清样本，发现 A-CIDP（缓解期）的 UA 水平明显高于 AIDP（康复期）（298.9±90.39μmol/L）（p=0.009）。
这些结果表明，血清 UA 水平有助于以较高的特异性和敏感性区分 AIDP 和 A-CIDP，这有助于早期诊断和治疗指导。
