What blood tests have you done?
July 1, 2014 at 4:41 pm
Literally tons of tests, yet none whose results would change the recommended choice of treatment for CIDP. Refer to the GBS_CIDP webpage for more.
According to one expert you would diagnose as follows:
Diagnostic criteria — There is general agreement that the following criteria support the diagnosis of the classic form of CIDP:
●Progression over at least two months
●Weakness more than sensory symptoms
●Symmetric involvement of arms and legs
●Proximal muscles involved along with distal muscles
●Reduced deep tendon reflexes throughout
●Increased cerebrospinal fluid protein without pleocytosis
●Nerve conduction evidence of a demyelinating neuropathy
●Nerve biopsy evidence of segmental demyelination with or without inflammation
for more on this you can click on-
July 1, 2014 at 5:45 pm
At any rate, in an attempt to better answer your question, according to the Journal of the Peripheral Nervous System 15:1–9 (2010)-
. Investigations to be considered.
To diagnose chronic inflammatory demyelinating polyradiculoneuropathy
Electrodiagnostic studies including sensory and motor nerve conduction studies, which may be repeated, performed bilaterally, or use proximal stimulation for motor nerves
CSF examination including cells and protein
MRI spinal roots, brachial plexus, and lumbosacral plexus
To detect concomitant diseases (<span style=”color: green;”>and, in my experience to rule things out as much as to rule CIDP in</span>)
(a)Serum and urine paraprotein detection by immunofixation*
Fasting blood glucose
Complete blood count
(b) Studies to be performed if clinically indicated
Oral glucose tolerance test
Borrelia burgdorferi serology
C reactive protein
Extractable nuclear antigen antibodies
To detect hereditary neuropathy:
Examination of parents and siblings
Appropriate gene testing (especially PMP22 duplication and connexin 32 mutations)
*Repeating these should be considered in patients who are or
become unresponsive to treatment.
Still, it is unrealistic to expect to find a ‘rogue’ antibody.
The proper use, understanding and interpretation, of this sort of testing is tone reason for everyone to consider finding a GBS-CIDP Center of Excellence.
July 2, 2014 at 3:42 am
I was in hospital with CIDP, where comprehensive blood testing is done daily for most patients. This is routine, because hospitals want to detect any complications as soon as possible, regardless of the principal diagnosis for the patient. Common tests are Complete Blood Count (CBC) and Basic Metabolic Panel (BMP). I don’t know what other tests were run.
CIDP was diagnosed for me on the basis of its presentation and the spinal fluid test. Blood tests didn’t have anything to do with my neuropathy. As far as I know, no one was trying to identify the antibody responsible for the neuropathy. When I developed blood clots as a side effect of being immobile, I was put on warfarin (a blood thinner). Then a Prothrombin Time/International Normalized Ratio (PT/INR) test was required while I was on it.
Out of hospital, my neurologist wanted a blood test monthly to check for reactions to my medication, but that has been cut back to once every three months.
My advice is to leave the matter of blood tests up to your doctors. They know what they need and you, likely, do not.
As for Centers of Excellence (CoE), it’s good if you have one, but not necessarily something to be concerned about if you do not. The most important advantage is in the ability to resolve an uncertain diagnosis. Neurologists with insufficient experience may have more difficulty with the differential diagnosis, because neuropathies are inherently difficult to diagnose. But if your disorder is clearly CIDP, you should be able to get adequate treatment without a CoE. Most CIDP and GBS patients are not treated at a CoE.
My hospital was not a CoE. But I had two excellent and experienced neurologists who were able to diagnose my disorder without much difficulty, and the hospital had the equipment I needed and highly skilled apheresis nurses and other specialists to give me the treatment I needed. My second neurologist came in as a consultant — I didn’t request a second opinion.
If your diagnosis and treatment isn’t working out, then you may need a second opinion, in which case seeking out a CoE could be advantageous if it is practical for you to do so.
I hope it all works out well for you.
July 2, 2014 at 4:00 am
Here’s some information on blood tests from the Foundation for Peripheral Neuropathy:
Blood tests are commonly employed to check for vitamin deficiencies, toxic elements and evidence of an abnormal immune response.
Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes for neuropathy. These include tests for:
Vitamin B12 and folate levels
Thyroid, liver and kidney functions
Oral glucose tolerance test
Antibodies to nerve components (e.g., anti-MAG antibody)
Antibodies related to celiac disease
Hepatitis C and B”
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