Neuropathy immune-mediated

Neuropathy in human immunodeficiency virus infection has many causes. Multiple mechanisms cause neuropathy in patients with HIV. An immune-mediated, Guillain-Barre-like syndrome (see below) may occur at the time of HIV seroconversion. Later in the course of infection, patients may present with mononeuropathy multiplex, sometimes as a consequence of vasculitis associated with coinfection with hepatitis C. Distal sensory-autonomic axonal polyneuropathy may develop in patients with more advanced HIV, either as a consequence of high titers of HIV itself or of the neurotoxicity of antiretroviral drugs [18,19],... 

Some human peripheral neuropathies involving demyelination are immune-mediated 645... 

This case suggests that acute polyradiculoneuropathy may represent a rare but serious adverse effect of statin treatment. The pathophysiology of acute neuropathy on statin exposure is unknown a hypersensitivity reaction resulting in an immune-mediated process has been suggested. It is possible that this patient had relapsing Guillain-Barre syndrome unrelated to the use of statins. 

In lymphoproliferative disease, sensory-motor neuropathy may be a result of diffuse malignant nerve infiltration or immune-mediated mechanisms [120], Syndromes similar to Guillain Barre syndrome sometimes occur among patients with lymphoproliferative disease, but in this group, it is uncertain whether cancer by itself favors the development of Guillain-Barre syndrome by suppressing immunosurveillance mechanisms [121]. 

Thom, S.R., Bhopale, V.M., Fisher, D., Zhang, J., Gimotty, P., Forster, R.E. (2004). Delayed neuropathy after carbon monoxide poisoning is immune-mediated. Proc. Natl Acad. Set USA 101 13660-5. 

Martini R, Toyka KV (2004) Immune-mediated components of hereditary demyelinating neuropathies Lessons from animal models and patients. Lancet Neurol 3 457-465. 

Merkies IS, Schmitz PI, Samijn JP, van der Meche EG, van Doom PA (1999) Fatigue in immune-mediated polyneuropathies. Europeau Inflammatory Neuropathy Cause aud Treatmeut (INCAT) Group. Neurology 53 1648-1654. 

Complementary to vascular compromise and mechanically impaired axoplasmic flow, additional pathogenic mechanisms (Figures 30.3 30.4) that underlie glaucomatous optic neuropathy include excitotoxic damage from excessive retinal glutamate, peroxynitrite toxicity from increased nitric oxide synthase activity, immune-mediated nerve damage, and oxidative stress (Naskar and Dreyer, 2001). 

Merkies IS, Schmitz PI, van der Meche FG, Inflammatory Neuropathy Cause and Treatment (INCAT) Group et al (2000) Psychometric evaluation of a new sensory scale in immune-mediated polyneuropathies. Neurology 54 943-949... 

The paraneoplastic syndromes of the nervous system arise in association with a cancer (Darnell Posner, 2003). However, the neurological symptoms are characteristic of certain types of cancer and often precede the identification of the underlying malignancy. Therefore, proper identification of the neurological disorder will be of help in finding the cancer that causes the neurological disability. Most of these disorders are immune-mediated and characterized by the presence of autoantibodies. Sensory neuropathy and limbic... 

Distal sensory neuropathy AIDS Subacute or chronic Distal sensory loss and neuropathic pain depressed or absent ankle reflexes Immune dysfunction macrophage-mediated axonal injury... 

Acute inflammatory demyelinating polyradiculopathy Early pre-AIDS Acute Motor to sensory signs NCS show demyelinating features Immune dysfunction complement/macrophage-mediated demyelinating neuropathy... 

Autonomic neuropathy AIDS, sometimes early Subacute or chronic Orthostatic hypotension papillary abnormalities sweating dysfunction resting tachycardia Immune dysfunction macrophage-mediated sympathetic ganglia injury... 

Infections can damage nerves directly, or via exotoxins 621 Antibody- and cell-mediated mechanisms of neuropathy 621 Immune mechanisms contribute to paraneoplastic neuropathies 623 Toxins and hormone deficiency states are frequent causes of neuropathy 623 Many genetically determined neuropathies are now recognized 624 Neurofibromatosis is a frequent cause of peripheral nerve tumors 625... 

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