Diagnostic and therapeutic challenges in chronic inflammatory demyelinating polyneuropathy and other immune-mediated neuropathies.
Résumé
PURPOSE OF REVIEW: Immune-mediated neuropathies are increasingly recognized as potential causes of disability. Their diagnostic criteria and management options are still a matter of debate. This review focuses on recent findings in the diagnostic and therapeutic management of these disorders and on their prognostic factors. RECENT FINDINGS: The more widespread use of consensus criteria has improved diagnostic strategies for immune-mediated neuropathies. Studies of large prospective series have defined the spectrum of these disorders and their respective prognoses. Although treatment of these disorders mostly relies on corticosteroids and intravenous immunoglobulin, recent controlled trials have indicated the value of targeted immunotherapies. The further development of these therapies requires better understanding of the pathophysiology of these disorders. Immunological and immunopathological studies have improved our understanding of immune-mediated neuropathies over the last few years. SUMMARY: Identifying immune-mediated neuropathies is important, as these disorders are treatable. Diagnostic strategies have improved our capacity to recognize affected patients who can be offered effective treatments. Therapeutic options for immune-mediated neuropathies are still rather limited, although targeted immunotherapies may improve the prognosis of these disorders in the near future.