CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Al-Hakem Helle, Doets Alex Y, Stino Amro Maher, Zivkovic Sasha A, Andersen Henning, Willison Hugh J, Cornblath David R, Gorson Kenneth C, Islam Zhahirul, Mohammad Quazi Deen, Sindrup Søren Hein, Kusunoki Susumu, Davidson Amy, Casasnovas Carlos, Bateman Kathleen, Miller James A L, van den Berg Bianca, Verboon Christine, Roodbol Joyce, Leonhard Sonja E, Arends Samuel, Luijten Linda W G, Benedetti Luana, Kuwabara Satoshi, Van den Bergh Peter, Monges Soledad, Marfia Girolama A, Shahrizaila Nortina, Galassi Giuliana, Pereon Yann, Bürmann Jan, Kuitwaard Krista, Kleyweg Ruud P, Marchesoni Cintia, Sedano Tous María J, Querol Luis, Martín-Aguilar Lorena, Wang Yuzhong, Nobile-Orazio Eduardo, Rinaldi Simon, Schenone Angelo, Pardo Julio, Vermeij Frederique H, Waheed Waqar, Lehmann Helmar C, Granit Volkan, Stein Beth, Cavaletti Guido, Gutiérrez-Gutiérrez Gerardo, Barroso Fabio A, Visser Leo H, Katzberg Hans D, Dardiotis Efthimios, Attarian Shahram, van der Kooi Anneke J, Eftimov Filip, Wirtz Paul W, Samijn Johnny P A, Gilhuis H Jacobus, Hadden Robert D M, Holt James K L, Sheikh Kazim A, Kolb Noah, Karafiath Summer, Vytopil Michal, Antonini Giovanni, Feasby Thomas E, Faber Catharina, Kramers Hans, Busby Mark, Roberts Rhys C, Silvestri Nicholas J, Fazio Raffaella, van Dijk Gert W, Garssen Marcel P J, Verschuuren Jan, Harbo Thomas, Jacobs Bart C, IGOS Consortium
Аннотация
METHODS: Albuminocytologic dissociation (ACD) was defined as an increased protein level (>0.45 g/L) in the absence of elevated white cell count (<50 cells/μL). We excluded 124 (8%) patients because of other diagnoses, protocol violation, or insufficient data. The CSF was examined in 1,231 patients (89%).
RESULTS: In 846 (70%) patients, CSF examination showed ACD, which increased with time from weakness onset: ≤4 days 57%, >4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness, and a reduced likelihood of being able to run at week 2 (odds ratio [OR] 0.42, 95% CI 0.25-0.70; p = 0.001) and week 4 (OR 0.44, 95% CI 0.27-0.72; p = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness, and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was <5 cells/μL in 1,005 patients (83%), 5-49 cells/μL in 200 patients (16%), and ≥50 cells/μL in 13 patients (1%).
DISCUSSION: ACD is a common finding in GBS, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely ≥50 cells/μL, is compatible with GBS after a thorough exclusion of alternative diagnoses.
CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that CSF ACD (defined by the Brighton Collaboration) is common in patients with GBS.