新的慢性炎症性脱髓鞘多发性神经病/吉兰-巴雷综合征指南--对临床实践的影响。

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Current Opinion in Neurology Pub Date : 2024-10-01 Epub Date: 2024-06-14 DOI:10.1097/WCO.0000000000001290
Jeffrey A Allen
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引用次数: 0

摘要

综述的目的:目前还没有一种诊断生物标志物能可靠地检测出格林-巴利综合征(GBS)或慢性炎症性脱髓鞘多发性神经病(CIDP)。诊断需要综合关键临床特征和相关辅助数据。因此,误诊和延迟诊断很常见。诊断标准已被证明是改善诊断的宝贵资源,但在常规临床护理中却未得到充分利用:2021 年,EAN/PNS CIDP 标准发布,随后于 2023 年发布了 EAN/PNS GBS 标准。总结:EAN/PNS GBS 和 CIDP 标准详细说明了特定的临床、电生理学和实验室特征,这些特征提高了诊断的可信度,并呼吁关注诊断模拟。EAN/PNS 和其他现代标准检测 GBS 和 CIDP 的灵敏度很高,但在临床实践中的使用率却很低。复杂性是限制广泛应用的一个因素。我们需要制定策略来优化常规临床护理中的标准应用,从而提高 GBS 和 CIDP 诊断的速度和准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New chronic inflammatory demyelinating polyneuropathy/Guillain-Barré syndrome guidelines - impact on clinical practise.

Purpose of review: There is no diagnostic biomarker that can reliably detect Guillain-Barré syndrome (GBS) or chronic inflammatory demyelinating polyneuropathy (CIDP). Diagnosis relies upon integrating key clinical characteristics and relevant supportive data. Consequently, misdiagnosis and delayed diagnosis are common. Diagnostic criteria have proven valuable resources to improve diagnosis, but are underutilized during routine clinical care.

Recent findings: In 2021, the EAN/PNS CIDP criteria was published, and were followed by the EAN/PNS GBS criteria in 2023. Both guidelines utilized GRADE methodology to formulate evidence-based recommendations that are intended to be used by adult and paediatric clinicians across diverse care settings to optimize diagnostic accuracy and improve patient outcomes during routine clinical care.

Summary: The EAN/PNS GBS and CIDP criteria detail specific clinical, electrophysiological, and laboratory features that raise diagnostic confidence, and call attention to diagnostic mimics. The sensitivity of EAN/PNS and other modern criteria to detect GBS and CIDP is high, but utilization during clinical practice is low. Complexity is one factor limiting widespread application. Strategies are needed to optimize criteria adoption during routine clinical care such that GBS and CIDP diagnosis can be achieved with greater speed and accuracy.

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来源期刊
Current Opinion in Neurology
Current Opinion in Neurology 医学-临床神经学
CiteScore
8.60
自引率
0.00%
发文量
174
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Neurology is a highly regarded journal offering insightful editorials and on-the-mark invited reviews; covering key subjects such as cerebrovascular disease, developmental disorders, neuroimaging and demyelinating diseases. Published bimonthly, each issue of Current Opinion in Neurology introduces world renowned guest editors and internationally recognized academics within the neurology field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.
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