Premium
Elevated leukocyte count in cerebrospinal fluid of patients with chronic inflammatory demyelinating polyneuropathy
Author(s) -
Lucke Ilse M.,
Peric Stojan,
van Lieverloo Gwen G. A.,
Wieske Luuk,
Verhamme Camiel,
van Schaik Ivo N.,
Basta Ivana,
Eftimov Filip
Publication year - 2018
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/jns.12250
Subject(s) - chronic inflammatory demyelinating polyneuropathy , medicine , pleocytosis , cerebrospinal fluid , polyradiculoneuropathy , csf pleocytosis , lumbar puncture , work up , polyneuropathy , gastroenterology , guillain barre syndrome , pathology , immunology , antibody
Cerebrospinal fluid (CSF) examination is often part of the diagnostic work‐up of a patient suspected of having chronic inflammatory demyelinating polyneuropathy (CIDP). According to the European Federation of Neurological Societies and the Peripheral Nerve Society (EFNS/PNS) criteria, an elevated protein level without pleocytosis (leukocytes <10 cells/µl) is supportive of the diagnosis CIDP. It is unclear how many CSF leukocytes are compatible with the diagnosis CIDP and how extensive the diagnostic work‐up should be in patients with a demyelinating neuropathy and pleocytosis. We performed a retrospective study at two tertiary neuromuscular referral clinics and identified 14 out of 273 (6%) patients with CIDP with elevated CSF leukocytes (≥10 cells/µl). All these patients met the EFNS/PNS criteria for definite or probable CIDP. Eight patients (57%) presented with a subacute onset and four patients with an antecedent infection. Most patients responded well to therapy, and eight patients are currently in remission. In four patients, lumbar puncture was repeated. A spontaneous decrease in leukocytes before start of treatment was found in three patients. Our data indicate that a mild to moderate pleocytosis in CSF does not exclude the diagnosis of CIDP, especially in patients with a subacute onset of disease.