Anesthesitic management for insulinoma resection in a patient having chronic inflammatory demyelinating neuropathy

2020 ◽  
Vol 49 (4) ◽  
pp. 500-563
Author(s):  
Raham Hasan Mostafa ◽  
Amr Amin Rashwan ◽  
Mohamed Mohamed AboKamar
Keyword(s):  
Female Patient ◽  
Clinical Characteristics ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Anesthetic Management ◽  
Young Female ◽  
Demyelinating Polyneuropathy ◽  
Demyelinating Neuropathy ◽  
Chronic Inflammatory Demyelinating Neuropathy ◽  
Inflammatory Demyelinating Polyneuropathy

Chronic Inflammatory Demyelinating Polyneuropathy associated with hypoglycemia 2 to insulinoma is unusual, and to our knowledge, very few patients have been reported in literature. Despite varying presentations in these patients, the clinical characteristics are usually the same. The syndrome usually occurs after several episodes of protracted hypoglycemia. The neuropathy is nearly always symmetrical. We report anesthetic management for a young female patient presenting with CIDP & repeated hypoglycemic episodes during a 2-year period scheduled for insulinoma enucleation.

Chronic Inflammatory Demyelinating Polyneuropathy in Diabetes Patients

US Neurology ◽  
2015 ◽  
Vol 11 (01) ◽  
pp. 47
Author(s):  
Alon Abraham ◽  
Majed Alabdali ◽  
Mohammad Qrimli ◽  
Carolina Barnett ◽  
Hans D Katzberg ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Demyelinating Polyneuropathy ◽  
Poor Control ◽  
Sensorimotor Polyneuropathy ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Variable Combination ◽  
Type 1 Dm ◽  
Electrophysiologic Studies

Diabetes mellitus (DM) is pandemic, and is the leading global cause of polyneuropathy, most commonly, a distal symmetric sensorimotor polyneuropathy (DSP). By contrast, chronic inflammatory demyelinating polyneuropathy (CIDP) is rare, and characterized mainly by symmetrical proximal and distal muscles weakness. There are currently 15 sets of criteria using a variable combination of clinical, electrophysiologic, laboratory, and biopsy features to identify CIDP, but it is unclear if these criteria are the same in patients with and without DM. Slowed conduction velocity, a feature of demyelination, is observed in patients with type 1 DM with poor control, and the clinical characteristics of these patients differ from those who have CIDP and DM, suggesting a different pathophysiology. Treatment response rates in CIDP patients, with and without DM, are as high as 80 %, and it is recommended that treatment be started early to prevent secondary axonal loss. However, patients with type 1 DM with CIDP are far less likely to be treated than CIDP patients who do not have DM. In patients with type 1 DM with polyneuropathy who have prominent weakness or demyelination in electrophysiologic studies, a diagnosis of CIDP and a trial of therapy should be considered.

scholarly journals A comparison of IL-17 and IL-34 concentrations in the cerebrospinal fluid of patients with acute inflammatory demyelinating neuropathy and chronic inflammatory demyelinating polyneuropathy

2020 ◽  
Vol 66 (11) ◽  
pp. 1583-1588
Author(s):  
Hayriye Soytürk ◽  
Murat Yılmaz
Keyword(s):  
Cerebrospinal Fluid ◽  
Autoimmune Diseases ◽  
Clinical Evaluation ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Demyelinating Polyneuropathy ◽  
Demyelinating Neuropathy ◽  
Immunosuppressant Therapy ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
The Difference

SUMMARY OBJECTIVE: The role of interleukins, such as IL-17 and IL-34, in the pathogenesis of autoimmune diseases has been established in the literature. In the current study, we aimed to identify the concentrations of IL-17 (IL-17A, IL-17F) and IL-34 in the cerebrospinal fluid (CSF) of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and acute inflammatory demyelinating neuropathy (AIDN). METHODS: We included in this study 8 patients with CIDP (none of them receiving immunomodulatory or immunosuppressant therapy), 7 patients with Guillain-Barre syndrome (GBS, AIDN), and 7 control subjects. The CIDP and AIDN diagnoses were made by clinical evaluation and electrophysiological investigations according to international criteria. CSF samples were obtained appropriately, and the levels of IL-17A, IL-17F, and IL-34 were measured by ELISA kits. RESULTS: The concentrations of IL-17A, IL-17F, and IL-34 were higher in those with CIDP and AIDN compared to the controls (p=0.005, p=0.01, and p=0.001, respectively). While IL-34 levels were significantly higher in AIDN patients than in CIDP patients (p=0.04), there were no significant differences between the AIDN and CIDP groups with regard to the levels of IL-17A and IL-17F (p=0.4 and p=0.2, respectively) CONCLUSION: Our results indicate that IL-17A, IL-17F, and IL-34 levels may have a role in CIDP and AIDN. Furthermore, the difference in the IL-34 levels of patients with AIDN and CIDP may indicate an important difference between the pathogenesis of these two sets of the disease.

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