Inflammatory infiltrates in sural nerve biopsies in Guillain‐Barre syndrome and chronic inflammatory demyelinating neuropathy

B Schmidt, KV Toyka, R Kiefer, J Full… - Muscle & Nerve …, 1996 - Wiley Online Library
B Schmidt, KV Toyka, R Kiefer, J Full, HP Hartung, J Pollard
Muscle & Nerve: Official Journal of the American Association of …, 1996Wiley Online Library
Prompted by observations in experimental autoimmune neuritis we reanalyzed
immunohistochemically the inflammatory infiltrates in sural nerve biopsies of 22 cases with
Guillain‐Barré syndrome (GBS) and 13 cases with chronic inflammatory demyelinating
polyneuropathy (CIDP). Endoneurial infiltration of CD3+ T cells was found in 20 cases of
GBS (median 5.5 cells/mm2) and in 10 cases of CIDP (5 cells). Epineurial T cells were
present in all GBS cases (19.5 cells) and in 11 CIDP cases (21 cells). CD68+ macrophages …
Abstract
Prompted by observations in experimental autoimmune neuritis we reanalyzed immunohistochemically the inflammatory infiltrates in sural nerve biopsies of 22 cases with Guillain‐Barré syndrome (GBS) and 13 cases with chronic inflammatory demyelinating polyneuropathy (CIDP). Endoneurial infiltration of CD3+ T cells was found in 20 cases of GBS (median 5.5 cells/mm2) and in 10 cases of CIDP (5 cells). Epineurial T cells were present in all GBS cases (19.5 cells) and in 11 CIDP cases (21 cells). CD68+ macrophages were abundant in these neuropathies and often occurred in endoneurial perivascular clusters. In GBS subgroups the number of endoneurial T cells was significantly higher in patients with hypoesthesia and abnormal electrophysiological findings in the sural nerve. In CIDP hypoesthesia was associated with significantly higher numbers of macrophages. Our study also indicates that other factors including the time point of biopsy or previous corticosteroid treatment may influence the inflammatory cell profile. Quantifying cell infiltration may aid in establishing the diagnosis of an immunoneuropathy in patients with mild and noncharacteristic pathology. © 1996 John Wiley & Sons, Inc.
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