scholarly journals The Correlation Among the Immunoglobulin G Synthesis Rate, IgG Index and Albumin Quotient in Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Retrospective Case–Control Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Tu ◽  
Xuan Gong ◽  
Yuanyuan Zhang ◽  
Jiewei Peng ◽  
Wenyan Zhuo ◽  
...  

Background: The immunoglobulin G synthesis rate (IgG SR) and immunoglobulin G (IgG) index are indicators of abnormal intrathecal humoural immune responses, and the albumin quotient (QALB) is an indicator used to evaluate the completeness of the blood-cerebrospinal fluid barrier (BCB). No systematic reports regarding differences in Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are available. We assessed differences in the IgG SR, IgG index and QALB between GBS and CIDP patients in a Chinese cohort.Methods: A total of 234 patients were retrospectively enrolled in this study, and 167 clinically confirmed GBS and CIDP patients were selected. Meanwhile, 67 non-GBS and non-CIDP patients requiring cerebrospinal fluid (CSF) examination were enrolled as the control group. The IgG SR, IgG index and QALB were calculated using formulas. The relevant clinical data were subjected to statistical analysis.Results: Among the GBS and CIDP study groups and the control group, the QALB had the highest positive rate (80.00%) in the CIDP group (P < 0.01). The QALB stratification analysis showed that the ranges of 10 < QALB ≤ 30 were dominant in the GBS and CIDP groups, and the positive rate of CIDP was higher than that of GBS. Furthermore, a QALB ≤ 7 was dominant in the control group, and a QALB > 30 was dominant in the CIDP group. In receiver operating characteristic (ROC) curve analysis with the CIDP group as the trial group and the GBS group as the control group, the differences in the QALB were statistically significant (P < 0.01). To achieve a high specificity of 98~99%, the diagnostic cut-off value for the QALB was above 57.37 (sensitivity: 9.33%) or below 0.60 (sensitivity: 4.35%). Multivariate logistic regression analysis showed that the CIDP patients had a QALB higher than 57.37, and compared with that in the GBS patients, the difference in the QALB was statistically significant (P < 0.01).Conclusion: QALB elevation was associated with CIDP, while QALB values above 57.37 or below 0.60 had high specificity in differentiating between GBS and CIDP. In CIDP, the BCB is generally moderately to severely damaged; in GBS, the BCB is generally moderately damaged.

2006 ◽  
Vol 33 (S 1) ◽  
Author(s):  
V. Lehmensiek ◽  
S.D. Süßmuth ◽  
G. Tauscher ◽  
S. Felk ◽  
F. Gillardon ◽  
...  

Author(s):  
Rashid Iqbal ◽  
Muhammad Javaid Asad ◽  
Saima Siddiqi ◽  
Raja Tahir Mahmood ◽  
Muhamamd Baseer Shah ◽  
...  

Objective: To examine clinical features, biochemical markers, demographic features, antecedent infections, frequency and treatment strategies. Methods: This case-control study was conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan and District Headquarters Hospital (DHQ), Rawalpindi, Pakistan from 2018 to 2020. Ninety consecutive patients of Guillain-Barré syndrome (GBS) and 77 healthy controls were enrolled. Patients were diagnosed by clinical presentation, Nerve conduction study (NCS), Electromyography (EMG), Cerebrospinal fluid analysis (CSF) and biochemical profile. Data was analyzed on IBM SPSS version 23. Results: Symmetrical ascending weakness was the striking clinical feature. Mean age was 40.20±14.90 years and male to female ratio was 2.1:1. Acute inflammatory demyelinating polyneuropathy (AIDP) was found to be the most common electrophysiological variant of GBS (46%). There was considerable difference in Interleukin-17(IL-17) levels between GBS patients 23.12 ± 3.41 pg/ml and healthy controls 8.82 ± 2.49. Mean IL-17 level was markedly increased in GBS patients, P=0.006, P<0.05. Gastrointestinal infection was the most common preceding infection (56.66%). Mean CSF protein was 100.83 g/dl with ± 51.32 standard deviation and albumio cytologic dissociation (ACD) was different in all four variants of GBS, P= 0.005. Conclusion: GBS was presented by all ages. Males were more affected than females. About two third of GBS patients showed an antecedent infection before GBS onset. Increased levels of cytokine (IL-17) showed involvement of autoimmunity. ACD differentiated it from poliomyelitis. Plasmapheresis and intravenous immunoglobulin (IVIG) therapy were used to treat patients. Key words: Guillain-Barré Syndrome; cerebrospinal fluid; albuminocytologic dissociation; nerve conduction studies; variants; electromyography Continuous....


2020 ◽  
Author(s):  
Jingfeng Lin ◽  
Qiang Gao ◽  
Kang Xiao ◽  
Danfeng Tian ◽  
Wenyue Hu ◽  
...  

Abstract Background Guillain-Barre syndrome (GBS) is an acute, paralyzing, inflammatory peripheral nerve disease. For treatments of the Guillain-Barre Syndrome, there are many kinds of therapies for this diseases. For comparing all of the therapies, such as immunoglobulin, plasma exchanging, etc. in the treatment of Guillain-Barre Syndrome(GBS) to better inform clinical practice, we use Network meta analysis to get the outcome of the Guillain-Barre Syndrome. The protocol has been submitted to PROSPERO:CRD: 42019119178. Methods Web of Science, PubMed, Embase, and the Cochrane library were searched for related articles. We identified citations of these and included 26 trials comprising 2434 patients and control group human beings. Network meta-analysis (NMA) was performed with two kinds of outcomes. We carried on R software with gemtc package and JAGS software to calculate results for different therapies. The consistency of direct and indirect evidence was also assessed by R software. Results Concerning for two outcomes, there were no improvement observed in MTP and Pred compared with placebo. PE and IVIg were illustrated to be effective over Placebo. There was no significant difference between different doses and times of PE and IVIg. On consistency examination between direct and indirect evidences, there were no obvious heterogeneity between all of therapies. Funnel plots indicates the possibility of publication bias in this study are small. Conclusion PE or IVIg had a significant efficency for GBS patients. The effects of some combination treatments should be further explored. Corticosteroids had no significant effects on GBS.


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