{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:03:15Z","timestamp":1788454995218,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cerebrospinal fluid (CSF) albumincytologic dissociation represents a supportive diagnostic criterion of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).Few studies have investigated possible systemic or intrathecal humoral immune response activation in CIDP.<\/jats:p><jats:p>Aim of our study was to investigate whether the search of oligoclonal IgG bands (OCBs) might provide additional data helpful in CIDP diagnostic work-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty-eight consecutive patients with CIDP (34 men, mean age 59.4, range 16\u201383) were recruited. CSF analysis included nephelometric measurement of albumin and IgG concentrations, calculation of Q<jats:sub>ALB<\/jats:sub>, QAlb<jats:sub>LIM<\/jats:sub> and intrathecal IgG synthesis, and OCBs detection with isoelectric focusing. Data were compared with those from CSF and serum of 32 patients with Guillain-Barr\u00e9 syndrome (GBS), 18 patients with anti-myelin associated glycoprotein (MAG) antibody neuropathy, 4 patients with multifocal motor neuropathy and 32 patients with non-inflammatory neuropathies (NINPs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with CIDP and anti-MAG antibody neuropathy had significantly higher CSF albumin concentrations and Q<jats:sub>ALB<\/jats:sub> values than NINPs (p=0.0003\u2009and p=0.0095, respectively). A total of 9 (19%) patients with CIDP presented identical serum and CSF OCBs (\u2018mirror pattern\u2019) versus 3 patients (16.6%) with anti-MAG antibody neuropathy, 13 patients (40.6%) with GBS and 12.5% patients with NINPs. Only one patient with CIDP showed unique-to-CSF OCBs. First-line therapy was effective in 80.4% of patients with CIDP, irrespective of CSF findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared with NINP, CIDP, GBS and anti-MAG antibody neuropathies had a significantly increased CSF protein and blood\u2013spinal nerve root barrier damage. Intrathecal humoral immune response is rare in our patients with CIDP. Systemic oligoclonal activation is more frequent, but not significantly different from what was detected in the control groups.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2020-325868","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T19:59:57Z","timestamp":1618343997000},"page":"969-974","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Oligoclonal IgG bands in chronic inflammatory polyradiculoneuropathies"],"prefix":"10.1136","volume":"92","author":[{"given":"Marta","family":"Ruiz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Puthenparampil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Campagnolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Castellani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-7566","authenticated-orcid":false,"given":"Alessandro","family":"Salvalaggio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Ruggero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Toffanin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cacciavillani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Franciotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3855-5135","authenticated-orcid":false,"given":"Chiara","family":"Briani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"key":"2021092308400886000_92.9.969.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30144-9"},{"key":"2021092308400886000_92.9.969.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2009.02930.x"},{"key":"2021092308400886000_92.9.969.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001833"},{"key":"2021092308400886000_92.9.969.4","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12253"},{"key":"2021092308400886000_92.9.969.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.8.864"},{"key":"2021092308400886000_92.9.969.6","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/B978-0-12-804279-3.00009-5","volume-title":"Handbook of clinical neurology: cerebrospinal fluid in neurologic disorders","volume":"146","author":"Illes","year":"2018"},{"key":"2021092308400886000_92.9.969.7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/BF00313314","article-title":"Demonstration of oligoclonal immunoglobulin G in Guillain-Barr\u00e9 syndrome and lymphocytic meningoradiculitis by isoelectric focusing","volume":"226","author":"Kr\u00fcger","year":"1981","journal-title":"J Neurol"},{"key":"2021092308400886000_92.9.969.8","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/BF00314019","article-title":"Clinical significance of serum and CSF findings in the Guillain-Barr\u00e9 syndrome and related disorders","volume":"233","author":"Segurado","year":"1986","journal-title":"J Neurol"},{"key":"2021092308400886000_92.9.969.9","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/j.1445-5994.1991.tb00447.x","article-title":"Monoclonal immunoglobulin bands in the cerebrospinal fluid","volume":"21","author":"McCombe","year":"1991","journal-title":"Aust N Z J Med"},{"key":"2021092308400886000_92.9.969.10","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(95)00313-Q"},{"key":"2021092308400886000_92.9.969.11","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000055864.08740.CB"},{"key":"2021092308400886000_92.9.969.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0820-1"},{"key":"2021092308400886000_92.9.969.13","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00415-017-8480-5","article-title":"A multicenter study on the diagnostic significance of a single cerebrospinal fluid IgG band","volume":"264","author":"Ferraro","year":"2017","journal-title":"J Neurol"},{"key":"2021092308400886000_92.9.969.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.5.596"},{"key":"2021092308400886000_92.9.969.15","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1212\/WNL.0000000000001044","article-title":"Changing outcome in inflammatory neuropathies: Rasch-comparative responsiveness","volume":"83","author":"Draak","year":"2014","journal-title":"Neurology"},{"key":"2021092308400886000_92.9.969.16","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-318714"},{"key":"2021092308400886000_92.9.969.17","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1093\/clinchem\/30.7.1246","article-title":"Improved detection of oligoclonal IgG in cerebrospinal fluid by isoelectric focusing in agarose, double-antibody peroxidase labeling, and avidin-biotin amplification","volume":"30","author":"Olsson","year":"1984","journal-title":"Clin Chem"},{"key":"2021092308400886000_92.9.969.18","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1515\/cclm-2015-0253","article-title":"Upper reference limits for cerebrospinal fluid total protein and albumin quotient based on a large cohort of control patients: implications for increased clinical specificity","volume":"54","author":"Hegen","year":"2016","journal-title":"Clin Chem Lab Med"},{"key":"2021092308400886000_92.9.969.19","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1007\/s00415-018-09174-z","article-title":"Adult CSF total protein upper reference limits should be age-partitioned and significantly higher than 0.45 g\/L: a systematic review","volume":"266","author":"Breiner","year":"2019","journal-title":"J Neurol"},{"key":"2021092308400886000_92.9.969.20","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.8.897"},{"key":"2021092308400886000_92.9.969.21","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.153064"},{"key":"2021092308400886000_92.9.969.22","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26488"},{"key":"2021092308400886000_92.9.969.23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/jns.12362","article-title":"Sporadic hereditary neuropathies misdiagnosed as chronic inflammatory demyelinating polyradiculoneuropathy: pitfalls and red flags","volume":"25","author":"Campagnolo","year":"2020","journal-title":"J Peripher Nerv Syst"},{"key":"2021092308400886000_92.9.969.24","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.1.37"},{"key":"2021092308400886000_92.9.969.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0104205","article-title":"Severity and patterns of blood-nerve barrier breakdown in patients with chronic inflammatory demyelinating polyradiculoneuropathy: correlations with clinical subtypes","volume":"9","author":"Shimizu","year":"2014","journal-title":"PLoS One"},{"key":"2021092308400886000_92.9.969.26","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-319270"},{"key":"2021092308400886000_92.9.969.27","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.7.1459"},{"key":"2021092308400886000_92.9.969.28","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-302312"},{"key":"2021092308400886000_92.9.969.29","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-320741"},{"key":"2021092308400886000_92.9.969.30","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.117"},{"key":"2021092308400886000_92.9.969.31","doi-asserted-by":"publisher","DOI":"10.1007\/BF00319857"},{"key":"2021092308400886000_92.9.969.32","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410150612"},{"key":"2021092308400886000_92.9.969.33","doi-asserted-by":"publisher","DOI":"10.1007\/s004010050785"}],"container-title":["Journal of Neurology, Neurosurgery &amp; Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp-2020-325868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T01:14:57Z","timestamp":1632446097000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnnp.bmj.com\/lookup\/doi\/10.1136\/jnnp-2020-325868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,13]]},"references-count":33,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,8,13]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/jnnp-2020-325868"],"URL":"https:\/\/doi.org\/10.1136\/jnnp-2020-325868","relation":{},"ISSN":["0022-3050","1468-330X"],"issn-type":[{"value":"0022-3050","type":"print"},{"value":"1468-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,13]]}}}