A combined approach of Interleukin-8 and magnetic resonance neurography to differentiate Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.

BACKGROUND AND

OBJECTIVES

Early differentiation between Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) is often difficult due to overlapping clinical features. This study investigates cerebrospinal fluid (CSF) interleukin-8 (IL-8) levels and magnetic resonance neurography (MRN) findings as potential diagnostic biomarkers for distinguishing GBS from CIDP.

METHODS

This retrospective study included 130 patients, comprising 73 with GBS and 57 with CIDP. CSF samples were obtained at initial presentation, and IL-8 concentrations were quantified using flow cytometry. MRN was performed with maximum intensity projection to reconstruct the lumbosacral plexus, and cross-sectional areas (CSA) of lumbar nerve roots were measured. Statistical analyses involved independent t-tests, Wilcoxon rank-sum tests, Pearson's correlation coefficients, and receiver operating characteristic (ROC) curve analysis to assess diagnostic performance.

RESULTS

CSF IL-8 levels were significantly higher in GBS patients compared with CIDP patients. An optimal IL-8 cutoff value yielded 67.1 % sensitivity and 75.4 % specificity for distinguishing GBS from CIDP. MRN demonstrated significantly enlarged lumbar nerve root CSA in CIDP, particularly at the L4 root, with 76.1 % sensitivity and 92.5 % specificity. Combining CSF IL-8 levels with L4 nerve root CSA further improved diagnostic performance, achieving 89.0 % sensitivity and 80.7 % specificity.

CONCLUSION

The integration of CSF IL-8 measurement with MRN-based assessment of the lumbosacral plexus provides a clinically applicable approach to enhance the differentiation of GBS from CIDP, facilitating earlier diagnosis and guiding timely therapeutic decision-making.