| Abstract | Cilj: Analiza prevalencije, dobi, spola, tipa, distribucije, etiologije te nalaza antigangliozidnih antitijela kod ispitanika s elektroneurografski detektiranom polineuropatijom u laboratoriju za EMNG Poliklinike Glavić u Dubrovniku tijekom 2022. godine.
Ispitanici i metode: U ovom retrospektivnom istraživanju analizirani su rezultati elektroneurografske obrade provedene na 245 ispitanika. Kriterij uključenja u istraživanje bila je elektroneurografska detekcija polineuropatije različite etiologije. U istraživanje je uključeno 87 ispitanika s polineuropatijom.
Rezultati: Polineuropatije različite etiologije dijagnosticirane su kod 35,5% ispitanika, gotovo podjednako kod ispitanika muškog i ženskog spola, a najveći broj pacijenata činile su osobe u dobnom intervalu od 61 do 80 godina s udjelom od 67,81%. Prema tipu polineuropatije najzastupljenije su bile senzomotorne (56,32%) i senzo(motorne) (miješane, dominantno senzorne) polineuropatije (40,22%), dok su zabilježene samo dvije senzorne (2,30%) i jedna motorna polineuropatija (1,16%). Prema patološko-elektrofiziološkoj klasifikaciji polineuropatija najzastupljenije su bile demijelinizacijske (42,53%), potom aksonalne (39,08%) te miješane (18,39%). Prema stupnju težine polineuropatije najzastupljenije su bile polineuropatije umjerenog (57,47%) i blažeg (31,03%) stupnja. Prema distribuciji polineuropatije dominirala je afekcija nogu (88,5%), dok je afekcija ruku i nogu značajno rjeđa (11,5%). Prema etiološkoj klasifikaciji najbrojnije su bile dijabetička (18), toksičke (jatrogene + etilične) (12), autoimune (10), infektivne (COVID-19) (5), reumatološke (5), nasljedne (3), uzrokovane deficitom vitamina B12 (3), hipotireozom (3), preboljelim Guillain-Barreovim sindromom (3), kroničnom bubrežnom insuficijencijom (2) te deficitom folne kiseline (1). Zabilježen je jedan slučaj „critical illness“ polineuropatije. Kod 21 pacijenta nije utvrđena etiologija polineuropatije. Antigangliozidna protutijela su bila pozitivna kod 12,6% ispitanika, a najzastupljenija su bila anti-GD1a, anti-GM1 i anti-GQ1b.
Zaključci: EMNG obrada predstavlja zlatni standard u dijagnostici polineuropatija. Polineuropatije su uz kompresivne radikulopatije i kanalikularne sindrome najčešći klinički entiteti dijagnosticirani EMNG-om. Dijabetička polineuropatija je najčešći oblik polineuropatije u općoj populaciji. |
| Abstract (english) | Aim: Analysis of the prevalence, age, gender, type, distribution, etiology, and findings of anti-ganglioside antibodies in subjects with electroneurographically detected polyneuropathy in the EMNG laboratory of Glavić Polyclinic in Dubrovnik during 2022.
Patients and methods: In this retrospective study, the results of nerve conductive studies performed on 245 subjects were analyzed. The criterion for inclusion in the research was the detection of polyneuropathy of different etiologies. 87 patients with polyneuropathy were included in the research.
Results: Polyneuropathies of different etiologies were diagnosed in 35.5% of respondents, almost equally in male and female respondents, and the largest number of patients were people in the age range of 61 to 80 years, with a share of 67.81%. According to the type of polyneuropathy, the most common were sensorimotor (56.32%) and sensorimotor (mixed, dominantly sensory) polyneuropathies (40.22%), while only two sensory (2.30%) and one motor polyneuropathy (1,16%). According to the pathological-electrophysiological classification, the most common polyneuropathies were demyelinating (42.53%), followed by axonal (39.08%) and mixed (18.39%). According to the degree of severity of polyneuropathies, the most represented were polyneuropathies of moderate (57.47%) and mild (31.03%) degrees. According to the distribution of polyneuropathy, the affection of the legs dominated (88.5%), while the affection of the arms and legs was significantly less frequent (11.5%). According to the etiological classification, the most numerous were diabetic (18), toxic (iatrogenic + ethylic) (12), autoimmune (10), infectious (COVID-19) (5), rheumatological (5), hereditary (3), caused by vitamin B12 deficiency (3), hypothyroidism (3), recovered Guillain-Barre syndrome (3), chronic kidney failure (2), and folic acid deficiency (1). One case of "critical illness" polyneuropathy was recorded. In 21 patients, the etiology of polyneuropathy was not established. Anti-ganglioside antibodies were positive in 12.6% of subjects, and the most prevalent were anti-GD1a, anti-GM1, and anti-GQ1b.
Conclusions: Electromyography and nerve conduction studies represent the gold standard in the diagnosis of polyneuropathies. Along with compressive radiculopathy and entrapment syndromes, polyneuropathies are the most common clinical entities diagnosed by electromyography and nerve conduction studies. Diabetic polyneuropathy is the most common form of polyneuropathy in the general population. |
