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. 2021 Dec;64(6):657-661.
doi: 10.1002/mus.27374. Epub 2021 Jul 27.

Antecedent infections and vaccinations in chronic inflammatory demyelinating polyneuropathy: A European collaborative study

Yusuf A Rajabally  1   2 , Stojan Peric  3 , Ivo Bozovic  3 , Lay K Loo  1 , Aida Kalac  4 , Aleksa Palibrk  3 , Ivana Basta  3
Affiliations

Antecedent infections and vaccinations in chronic inflammatory demyelinating polyneuropathy: A European collaborative study

Yusuf A Rajabally et al. Muscle Nerve. 2021 Dec.

Abstract

Introduction/aims: Chronic inflammatory demyelinating polyneuropathy (CIDP) may be rarely preceded by infection. A causative link remains unproven, in contrast to Guillain-Barré syndrome (GBS), which is commonly postinfectious with well-demonstrated pathophysiological mechanisms of molecular mimicry following Campylobacter jejuni enteritis. Uncommonly, infections are reported before the onset of CIDP. In this study we aimed to determine the frequency and characteristics of CIDP occurring after antecedent infections or vaccinations in two large European cohorts.

Methods: We reviewed the records of 268 subjects with "definite" or "probable" CIDP from the Inflammatory Neuropathy Clinic, Birmingham, UK (129 subjects), and from the Serbian national CIDP database (139 subjects).

Results: Twenty-five of 268 (9.3%) subjects had a respiratory or gastrointestinal infection in the 6 weeks preceding CIDP onset, and 3 of 268 (1.1%) had received an influenza vaccination. CIDP disease onset occurred at a younger age (mean [standard deviation], 44.25 [17.36] years vs 54.05 [15.19] years; P < .005) and acute-onset CIDP was more common (42.9% vs 12.1%; odds ratio, 5.46; 95% confidence interval, 2.35-12.68; P < .001) in subjects with preceding infections or vaccinations. No differences in CIDP subtype, rates of cerebrospinal fluid protein level elevation, disability, or likelihood of treatment response, were observed.

Discussion: Antecedent infections or vaccinations may precede about 10% of cases of CIDP and are more common in younger subjects. Acute-onset CIDP is more frequent after antecedent events. These findings may suggest specific pathophysiological mechanisms in such cases.

Keywords: acute onset; chronic inflammatory demyelinating polyneuropathy; gastrointestinal; infection; respiratory; vaccination.

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References

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