Abstract
Chronic inflammatory demyelinating polyneuropathy (CIDP) in patients with diabetes mellitus (DM) occurs approximately 9—11 times more frequently than in the general population. Objective : to assess the characteristics of CIDP in the presence of DM. Patients and methods . A total of 109 patients with CIDP diagnosed according to the international EFNS/PNS criteria were examined. Seventeen patients had type 1 or 2 DM; the remaining 92 patients did not. Results and discussion . The patients with CIDP and DM were found to have significantly more obvious neurological deficit, lower levels of selfservice, and a shorter time to diagnose CIDP than those with CIDP without DM. The concurrence of CIDP and DM is ambiguously assessed. On the one hand, there are indications of a strict correlation between these conditions, and on the other, the absence of this association. Our study showed that more obvious neurological deficit in DM can be related to the additional damaging impact of chronic hyperglycemia as impaired metabolism of nerve fibers and deterioration of their trophism. The autoimmune nerve damage occurring in CIDP is superimposed on the already existing impairments in the microcirculation and dysfunction of peripheral nerves, thereby increasing their damage. Conclusion . The course of CIDP in the presence of DM differs from that of «pure» CIDP, which should be taken into account in managing these patients.
Highlights
Chronic inflammatory demyelinating polyneuropathy (CIDP) in patients with diabetes mellitus (DM) occurs approximately 9–11 times more frequently than in the general population
A total of 109 patients with CIDP diagnosed according to the international EFNS/PNS criteria were examined
Our study showed that more obvious neurological deficit in DM can be related to the additional damaging impact of chronic hyperglycemia as impaired metabolism of nerve fibers and deterioration of their trophism
Summary
Гапешин Р.А.1, Баранцевич Е.Р.1, Руденко Д.И.1,2, Стучевская Т.Р.1,2, Яковлев А.А.1,3 1ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. Обследовано 109 пациентов с ХВДП, доказанной согласно международным критериям EFNS/PNS. В России, по данным портала МЕД-инфо за 2011–2015 гг., распространенность ХВДП колеблется 1,24 до 1,9 случая на 100 тыс. Цель исследования – оценка влияния СД на степень тяжести, особенности диагностики и лабораторные показатели у пациентов с ХВДП. Обследовано 109 пациентов, находившихся на лечении в 3-м неврологическом отделении «Городской многопрофильной больницы No 2 Санкт-Петербурга и 2-м неврологическом отделении клиники Научноисследовательского института неврологии ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. Диагноз ХВДП устанавливали в соответствии с международными критериями European Federation of Neurological Societes/Peripheral Nerve Society (EFNS/PNS), учитывающими наличие характерной клинической картины и данные электронейромиографии (ЭНМГ) [6]. ХВДП впервые выявлена у 73 пациентов, остальные 36 больных уже имели диагноз ХВДП на момент поступления (у 29 из них было ремиттирующее течение заболевания и у 7 – прогрессирующее).
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