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Nodal and paranodal antibody-associated neuropathies
- Source :
- Practical Neurology. 21:284-291
- Publication Year :
- 2021
- Publisher :
- BMJ, 2021.
-
Abstract
- Within the last decade, antibodies targeting the node and paranode of myelinated peripheral nerves have been increasingly identified in patients with acquired immune-mediated neuropathies, commonly termed ‘nodo-paranodopathies’. Crucially, these patients often present with additional clinical features not usually seen with the most common immune-mediated neuropathies, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy, and respond poorly to conventionally used immunomodulatory therapies. Emerging evidence that these are pathologically distinct diseases has further prompted the use of more targeted treatment, such as the B cell depleting monoclonal antibody rituximab, which has been reported to significantly improve functional outcomes in this subset of patients. We provide an overview of the emerging clinical and serological phenotypes in patients with specific nodal/paranodal antibodies, the practicalities of antibody testing and current evidence supporting the use of non-standard therapies.
- Subjects :
- 0303 health sciences
Guillain-Barre syndrome
biology
business.industry
medicine.drug_class
Chronic inflammatory demyelinating polyneuropathy
General Medicine
medicine.disease
Monoclonal antibody
Serology
03 medical and health sciences
0302 clinical medicine
Neuroimmunology
medicine.anatomical_structure
Immunology
biology.protein
Medicine
Rituximab
Neurology (clinical)
Antibody
business
030217 neurology & neurosurgery
B cell
030304 developmental biology
medicine.drug
Subjects
Details
- ISSN :
- 14747766 and 14747758
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Practical Neurology
- Accession number :
- edsair.doi.dedup.....03541882de7e3119f5f410bc95c6d35c
- Full Text :
- https://doi.org/10.1136/practneurol-2021-002960