European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of paraproteinaemic demyelinating neuropathies: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society
Identifieur interne : 009998 ( Main/Exploration ); précédent : 009997; suivant : 009999European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of paraproteinaemic demyelinating neuropathies: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society
Auteurs : R. D. M. Hadden [Royaume-Uni] ; E. Nobile-Orazio [Italie] ; C. Sommer [Allemagne] ; A. Hahn [Canada] ; I. Illa [Espagne] ; E. Morra [Italie] ; J. Pollard [Australie] ; R. A. C. Hughes [Royaume-Uni] ; P. Bouche [France] ; D. Cornblath [États-Unis] ; E. Evers [Royaume-Uni] ; C. L. Koski [États-Unis] ; J. M. Léger [France] ; P. Van Den Bergh [Belgique] ; P. Van Doorn [Pays-Bas] ; I. N. Van Schaik [Pays-Bas]Source :
- European Journal of Neurology [ 1351-5101 ] ; 2006-08.
Descripteurs français
- Wicri :
- topic : Neurologie.
English descriptors
- KwdEn :
- Axonal, Axonal electrophysiology, Biopsy, Case reports, Causal relationship, Chronic demyelinating polyradiculoneuropathy, Cidp, Clinical features, Clinical phenotype, Corticosteroid, Dads phenotype, Demyelinating, Demyelinating neuropathy, Departmental research grants, Diagnostic criteria, Efns, Efns european journal, Electron microscopy, Electrophysiological, Electrophysiological features, Electrophysiology, European journal, Gammopathy, Glycoprotein, Good practice points, Guideline, Hadden, High titres, Immunoglobulin, Intravenous, Intravenous immunoglobulin, Ivig, Local radiation, Malignant, Malignant transformation, Many patients, Mgus, Monoclonal, Monoclonal gammopathies, Monoclonal gammopathy, Multiple myeloma, Myelin, Myeloma, Nerve biopsy, Neural antigens, Neurological, Neurological sciences, Neurology, Neuropathy, Osteosclerotic myeloma, Other therapies, Paraprotein, Paraproteinaemic, Paraproteinaemic demyelinating neuropathies guideline, Paraproteinaemic demyelinating neuropathy, Paraproteinaemic neuropathy, Peripheral neuropathy, Phenotype, Plasma exchange, Poems syndrome, Polyneuropathy, Rituximab, Sensory impairment, Syndrome, Task force, Uncontrolled studies.
- Teeft :
- Axonal, Axonal electrophysiology, Biopsy, Case reports, Causal relationship, Chronic demyelinating polyradiculoneuropathy, Cidp, Clinical features, Clinical phenotype, Corticosteroid, Dads phenotype, Demyelinating, Demyelinating neuropathy, Departmental research grants, Diagnostic criteria, Efns, Efns european journal, Electron microscopy, Electrophysiological, Electrophysiological features, Electrophysiology, European journal, Gammopathy, Glycoprotein, Good practice points, Guideline, Hadden, High titres, Immunoglobulin, Intravenous, Intravenous immunoglobulin, Ivig, Local radiation, Malignant, Malignant transformation, Many patients, Mgus, Monoclonal, Monoclonal gammopathies, Monoclonal gammopathy, Multiple myeloma, Myelin, Myeloma, Nerve biopsy, Neural antigens, Neurological, Neurological sciences, Neurology, Neuropathy, Osteosclerotic myeloma, Other therapies, Paraprotein, Paraproteinaemic, Paraproteinaemic demyelinating neuropathies guideline, Paraproteinaemic demyelinating neuropathy, Paraproteinaemic neuropathy, Peripheral neuropathy, Phenotype, Plasma exchange, Poems syndrome, Polyneuropathy, Rituximab, Sensory impairment, Syndrome, Task force, Uncontrolled studies.
Abstract
Background. Paraprotein‐associated neuropathies have heterogeneous clinical, neurophysiological, neuropathological and haematological features. Objectives. To prepare evidence‐based and consensus guidelines on the clinical management of patients with both a demyelinating neuropathy and a paraprotein (paraproteinaemic demyelinating neuropathy, PDN). Methods. Search of MEDLINE and the Cochrane library, review of evidence and consensus agreement of an expert panel. Recommendations. In the absence of adequate data, evidence based recommendations were not possible but the panel agreed the following good practice points: (1) Patients with PDN should be investigated for a malignant plasma cell dyscrasia. (2) The paraprotein is more likely to be causing the neuropathy if the paraprotein is immunoglobulin (Ig)M, antibodies are present in serum or on biopsy, or the clinical phenotype is chronic distal sensory neuropathy. (3) Patients with IgM PDN usually have predominantly distal and sensory impairment, with prolonged distal motor latencies, and often anti‐myelin associated glycoprotein antibodies. (4) IgM PDN sometimes responds to immune therapies. Their potential benefit should be balanced against their possible side‐effects and the usually slow disease progression. (5) IgG and IgA PDN may be indistinguishable from chronic inflammatory demyelinating polyradiculoneuropathy, clinically, electrophysiologically, and in response to treatment. (6) For POEMS syndrome, local irradiation or resection of an isolated plasmacytoma, or melphalan with or without corticosteroids, should be considered, with haemato‐oncology advice.
Url:
DOI: 10.1111/j.1468-1331.2006.01467.x
Affiliations:
- Allemagne, Australie, Belgique, Canada, Espagne, France, Italie, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Bavière, Catalogne, District de Basse-Franconie, Grand Londres, Hollande-Méridionale, Hollande-Septentrionale, Lombardie, Maryland, Nouvelle-Galles du Sud, Région de Bruxelles-Capitale, Île-de-France
- Amsterdam, Barcelone, Bruxelles, College Park (Maryland), Londres, Milan, Paris, Rotterdam, Sydney, Wurtzbourg
- Université de Sydney, Université du Maryland
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Le document en format XML
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Sommer</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Würzburg, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Hahn, A" sort="Hahn, A" uniqKey="Hahn A" first="A." last="Hahn">A. Hahn</name><affiliation wicri:level="3"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Clinical Neurological Sciences, University of Western Ontario, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Illa, I" sort="Illa, I" uniqKey="Illa I" first="I." last="Illa">I. Illa</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Neurology, Hospital Sta. Creu i Sant Pau, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Morra, E" sort="Morra, E" uniqKey="Morra E" first="E." last="Morra">E. Morra</name><affiliation wicri:level="3"><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Haematology, Niguarda Hospital, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Pollard, J" sort="Pollard, J" uniqKey="Pollard J" first="J." last="Pollard">J. Pollard</name><affiliation wicri:level="4"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medicine, University of Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Hughes, R A C" sort="Hughes, R A C" uniqKey="Hughes R" first="R. A. C." last="Hughes">R. A. C. Hughes</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Neurosciences, King's College, London School of Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bouche, P" sort="Bouche, P" uniqKey="Bouche P" first="P." last="Bouche">P. Bouche</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurophysiology, CHU Pitié‐Salpêtrière, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cornblath, D" sort="Cornblath, D" uniqKey="Cornblath D" first="D." last="Cornblath">D. Cornblath</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Johns Hopkins University, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Evers, E" sort="Evers, E" uniqKey="Evers E" first="E." last="Evers">E. Evers</name><affiliation wicri:level="1"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Lay Member, Guillain‐Barré Syndrome Support Group of the UK, Sleaford</wicri:regionArea><wicri:noRegion>Sleaford</wicri:noRegion></affiliation></author><author><name sortKey="Koski, C L" sort="Koski, C L" uniqKey="Koski C" first="C. L." last="Koski">C. L. Koski</name><affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, University of Maryland, Baltimore, MD</wicri:regionArea><placeName><region type="state">Maryland</region><settlement type="city">College Park (Maryland)</settlement></placeName><orgName type="university">Université du Maryland</orgName></affiliation></author><author><name sortKey="Leger, J M" sort="Leger, J M" uniqKey="Leger J" first="J. M." last="Léger">J. M. Léger</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, Faculté de Médecine Pitié‐Salpêtrière, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Van Den Bergh, P" sort="Van Den Bergh, P" uniqKey="Van Den Bergh P" first="P." last="Van Den Bergh">P. Van Den Bergh</name><affiliation wicri:level="3"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Neurology, Clinique Universitaire St‐Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Van Doorn, P" sort="Van Doorn, P" uniqKey="Van Doorn P" first="P." last="Van Doorn">P. Van Doorn</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Erasmus Medical Centre, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Van Schaik, I N" sort="Van Schaik, I N" uniqKey="Van Schaik I" first="I. N." last="Van Schaik">I. N. Van Schaik</name><affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Academic Medical Centre, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">European Journal of Neurology</title><title level="j" type="alt">EUROPEAN JOURNAL OF NEUROLOGY</title><idno type="ISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><imprint><biblScope unit="vol">13</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="809">809</biblScope><biblScope unit="page" to="818">818</biblScope><biblScope unit="page-count">10</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2006-08">2006-08</date></imprint><idno type="ISSN">1351-5101</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-5101</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axonal</term><term>Axonal electrophysiology</term><term>Biopsy</term><term>Case reports</term><term>Causal relationship</term><term>Chronic demyelinating polyradiculoneuropathy</term><term>Cidp</term><term>Clinical features</term><term>Clinical phenotype</term><term>Corticosteroid</term><term>Dads phenotype</term><term>Demyelinating</term><term>Demyelinating neuropathy</term><term>Departmental research grants</term><term>Diagnostic criteria</term><term>Efns</term><term>Efns european journal</term><term>Electron microscopy</term><term>Electrophysiological</term><term>Electrophysiological features</term><term>Electrophysiology</term><term>European journal</term><term>Gammopathy</term><term>Glycoprotein</term><term>Good practice points</term><term>Guideline</term><term>Hadden</term><term>High titres</term><term>Immunoglobulin</term><term>Intravenous</term><term>Intravenous immunoglobulin</term><term>Ivig</term><term>Local radiation</term><term>Malignant</term><term>Malignant transformation</term><term>Many patients</term><term>Mgus</term><term>Monoclonal</term><term>Monoclonal gammopathies</term><term>Monoclonal gammopathy</term><term>Multiple myeloma</term><term>Myelin</term><term>Myeloma</term><term>Nerve biopsy</term><term>Neural antigens</term><term>Neurological</term><term>Neurological sciences</term><term>Neurology</term><term>Neuropathy</term><term>Osteosclerotic myeloma</term><term>Other therapies</term><term>Paraprotein</term><term>Paraproteinaemic</term><term>Paraproteinaemic demyelinating neuropathies guideline</term><term>Paraproteinaemic demyelinating neuropathy</term><term>Paraproteinaemic neuropathy</term><term>Peripheral neuropathy</term><term>Phenotype</term><term>Plasma exchange</term><term>Poems syndrome</term><term>Polyneuropathy</term><term>Rituximab</term><term>Sensory impairment</term><term>Syndrome</term><term>Task force</term><term>Uncontrolled studies</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Axonal</term><term>Axonal electrophysiology</term><term>Biopsy</term><term>Case reports</term><term>Causal relationship</term><term>Chronic demyelinating polyradiculoneuropathy</term><term>Cidp</term><term>Clinical features</term><term>Clinical phenotype</term><term>Corticosteroid</term><term>Dads phenotype</term><term>Demyelinating</term><term>Demyelinating neuropathy</term><term>Departmental research grants</term><term>Diagnostic criteria</term><term>Efns</term><term>Efns european journal</term><term>Electron microscopy</term><term>Electrophysiological</term><term>Electrophysiological features</term><term>Electrophysiology</term><term>European journal</term><term>Gammopathy</term><term>Glycoprotein</term><term>Good practice points</term><term>Guideline</term><term>Hadden</term><term>High titres</term><term>Immunoglobulin</term><term>Intravenous</term><term>Intravenous immunoglobulin</term><term>Ivig</term><term>Local radiation</term><term>Malignant</term><term>Malignant transformation</term><term>Many patients</term><term>Mgus</term><term>Monoclonal</term><term>Monoclonal gammopathies</term><term>Monoclonal gammopathy</term><term>Multiple myeloma</term><term>Myelin</term><term>Myeloma</term><term>Nerve biopsy</term><term>Neural antigens</term><term>Neurological</term><term>Neurological sciences</term><term>Neurology</term><term>Neuropathy</term><term>Osteosclerotic myeloma</term><term>Other therapies</term><term>Paraprotein</term><term>Paraproteinaemic</term><term>Paraproteinaemic demyelinating neuropathies guideline</term><term>Paraproteinaemic demyelinating neuropathy</term><term>Paraproteinaemic neuropathy</term><term>Peripheral neuropathy</term><term>Phenotype</term><term>Plasma exchange</term><term>Poems syndrome</term><term>Polyneuropathy</term><term>Rituximab</term><term>Sensory impairment</term><term>Syndrome</term><term>Task force</term><term>Uncontrolled studies</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Neurologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background. Paraprotein‐associated neuropathies have heterogeneous clinical, neurophysiological, neuropathological and haematological features. Objectives. To prepare evidence‐based and consensus guidelines on the clinical management of patients with both a demyelinating neuropathy and a paraprotein (paraproteinaemic demyelinating neuropathy, PDN). Methods. Search of MEDLINE and the Cochrane library, review of evidence and consensus agreement of an expert panel. Recommendations. In the absence of adequate data, evidence based recommendations were not possible but the panel agreed the following good practice points: (1) Patients with PDN should be investigated for a malignant plasma cell dyscrasia. (2) The paraprotein is more likely to be causing the neuropathy if the paraprotein is immunoglobulin (Ig)M, antibodies are present in serum or on biopsy, or the clinical phenotype is chronic distal sensory neuropathy. (3) Patients with IgM PDN usually have predominantly distal and sensory impairment, with prolonged distal motor latencies, and often anti‐myelin associated glycoprotein antibodies. (4) IgM PDN sometimes responds to immune therapies. Their potential benefit should be balanced against their possible side‐effects and the usually slow disease progression. (5) IgG and IgA PDN may be indistinguishable from chronic inflammatory demyelinating polyradiculoneuropathy, clinically, electrophysiologically, and in response to treatment. (6) For POEMS syndrome, local irradiation or resection of an isolated plasmacytoma, or melphalan with or without corticosteroids, should be considered, with haemato‐oncology advice.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Canada</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Bavière</li><li>Catalogne</li><li>District de Basse-Franconie</li><li>Grand Londres</li><li>Hollande-Méridionale</li><li>Hollande-Septentrionale</li><li>Lombardie</li><li>Maryland</li><li>Nouvelle-Galles du Sud</li><li>Région de Bruxelles-Capitale</li><li>Île-de-France</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Bruxelles</li><li>College Park (Maryland)</li><li>Londres</li><li>Milan</li><li>Paris</li><li>Rotterdam</li><li>Sydney</li><li>Wurtzbourg</li></settlement><orgName><li>Université de Sydney</li><li>Université du Maryland</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Hadden, R D M" sort="Hadden, R D M" uniqKey="Hadden R" first="R. D. M." last="Hadden">R. D. M. Hadden</name></region><name sortKey="Evers, E" sort="Evers, E" uniqKey="Evers E" first="E." last="Evers">E. Evers</name><name sortKey="Hughes, R A C" sort="Hughes, R A C" uniqKey="Hughes R" first="R. A. C." last="Hughes">R. A. C. Hughes</name></country><country name="Italie"><region name="Lombardie"><name sortKey="Nobile Razio, E" sort="Nobile Razio, E" uniqKey="Nobile Razio E" first="E." last="Nobile-Orazio">E. Nobile-Orazio</name></region><name sortKey="Morra, E" sort="Morra, E" uniqKey="Morra E" first="E." last="Morra">E. Morra</name></country><country name="Allemagne"><region name="Bavière"><name sortKey="Sommer, C" sort="Sommer, C" uniqKey="Sommer C" first="C." last="Sommer">C. Sommer</name></region></country><country name="Canada"><region name="Angleterre"><name sortKey="Hahn, A" sort="Hahn, A" uniqKey="Hahn A" first="A." last="Hahn">A. Hahn</name></region></country><country name="Espagne"><region name="Catalogne"><name sortKey="Illa, I" sort="Illa, I" uniqKey="Illa I" first="I." last="Illa">I. Illa</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Pollard, J" sort="Pollard, J" uniqKey="Pollard J" first="J." last="Pollard">J. Pollard</name></region></country><country name="France"><region name="Île-de-France"><name sortKey="Bouche, P" sort="Bouche, P" uniqKey="Bouche P" first="P." last="Bouche">P. Bouche</name></region><name sortKey="Leger, J M" sort="Leger, J M" uniqKey="Leger J" first="J. M." last="Léger">J. M. Léger</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Cornblath, D" sort="Cornblath, D" uniqKey="Cornblath D" first="D." last="Cornblath">D. Cornblath</name></region><name sortKey="Koski, C L" sort="Koski, C L" uniqKey="Koski C" first="C. L." last="Koski">C. L. Koski</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Van Den Bergh, P" sort="Van Den Bergh, P" uniqKey="Van Den Bergh P" first="P." last="Van Den Bergh">P. Van Den Bergh</name></region></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Doorn, P" sort="Van Doorn, P" uniqKey="Van Doorn P" first="P." last="Van Doorn">P. Van Doorn</name></region><name sortKey="Van Schaik, I N" sort="Van Schaik, I N" uniqKey="Van Schaik I" first="I. N." last="Van Schaik">I. N. Van Schaik</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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