Immune‐mediated diseases involving central and peripheral nervous systems
- Type de publi. : Article dans une revue
- Date de publi. : 01/02/2023
-
Auteurs :
Aurelie LeboyanFlorence EsselinAnne‐laure BascouClaire DuflosIoana IonMahmoud CharifGiovanni CastelnovoClarisse Carra DallièreXavier AyrignacPhilippe KerschenMohamed ChbichebLudovic NguyenAlexandre MariaPhilippe GuilpainMathilde CarriereNicolas Menjot de ChampfleurThierry VincentAlexandre JentzerPierre LabaugeJérôme J. DevauxGuillaume Taieb
-
Organismes :
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Hôpital Universitaire Carémeau [Nîmes]
Centre Hospitalier Régional Universitaire [Montpellier]
Hôpital Universitaire Carémeau [Nîmes]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier de Luxembourg [Luxembourg]
Centre Hospitalier de Narbonne
Centre Hospitalier Saint Jean de Perpignan
Hôpital Saint Eloi [CHU Montpellier]
Hôpital Saint Eloi [CHU Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Hôpital Saint Eloi [CHU Montpellier]
Hôpital Saint Eloi [CHU Montpellier]
Centre Hospitalier Régional Universitaire [Montpellier]
Institut de Génomique Fonctionnelle
Centre Hospitalier Régional Universitaire [Montpellier]
Institut de Génomique Fonctionnelle
- Publié dans European Journal of Neurology le 22/10/2020
Résumé : Background and purpose: In addition to combined central and peripheral demyelination, other immune diseases could involve both the central nervous system (CNS) and peripheral nervous system (PNS). Methods: To identify immune-mediated diseases responsible for symptomatic combined central/peripheral nervous system involvement (ICCPs), we conducted a multicentric retrospective study and assessed clinical, electrophysiological, and radiological features of patients fulfilling our ICCP criteria. Results: Thirty patients (20 males) were included and followed during a median of 79.5 months (interquartile range [IQR] = 43-145). The median age at onset was 51.5 years (IQR = 39-58). Patients were assigned to one of four groups: (i) monophasic disease with concomitant CNS/PNS involvement including anti-GQ1b syndrome (acute polyradiculoneuropathy + rhombencephalitis, n = 2), checkpoint inhibitor-related toxicities (acute polyradiculoneuropathy + encephalitis, n = 3), and anti-glial fibrillary acidic protein astrocytopathy (subacute polyradiculoneuropathy and meningoencephalomyelitis with linear gadolinium enhancements, n = 2); (ii) chronic course with concomitant CNS/PNS involvement including paraneoplastic syndromes (ganglionopathy/peripheral hyperexcitability + limbic encephalitis, n = 4); (iii) chronic course with sequential CNS/PNS involvement including POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) syndrome (polyradiculoneuropathy + strokes, n = 2), histiocytosis (polyradiculoneuropathy + lepto-/pachymeningitis, n = 1), and systemic vasculitis (multineuropathy + CNS vasculitis/pachymeningitis, n = 2); and (iv) chronic course with concomitant or sequential CNS/PNS involvement including combined central and peripheral demyelination (polyradiculoneuropathy + CNS demyelinating lesions, n = 10) and connective tissue diseases (ganglionopathy/radiculopathy/multineuropathy + limbic encephalitis/transverse myelitis/stroke, n = 4). Conclusions: We diagnosed nine ICCPs. The timing of central and peripheral manifestations and the disease course help determine the underlying immune disease. When antibody against neuroglial antigen is identified, CNS and PNS involvement is systematically concomitant, suggesting a common CNS/PNS antigen and a simultaneous disruption of blood-nerve and blood-brain barriers.
Source