Polirradiculoneurite inflamatória em um hospital de Curitiba, uma análise retrospectiva de perfil epidemiológico
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TCC
Data de publicação
2024-11-21
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Citações (Scopus)
Autores
Perez, Maria Eduarda Botelho Vidoto
Alves, Rodrigo Moraes
Alves, Rodrigo Moraes
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Seefeld, Marcos
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INTRODUÇÃO: As Polineurites (Polineurite Inflamatória Crônica e Síndrome Guillain-Barré), apresentam-se com fraqueza bilateral e simétrica dos membros, apresentando também, reflexos miotáticos diminuídos ou ausentes. A doença ocorre mais em homens. O diagnóstico é clínico, entretanto, a dissociação albumino-citológica no líquido cefalorraquidiano e estudos eletrofisiológicos podem ajudar no diagnóstico e na diferenciação entre os tipos axonais e desmielinizantes. O método terapêutico consiste na aplicação de plasmaférese e imunoglobulina humana intravenosa e, eventualmente, corticosteroides. OBJETIVOS: Os objetivos consistem em reunir dados epidemiológicos dos pacientes admitidos no Hospital Evangélico Mackenzie, que apresentavam as polineurites inflamatórias, na forma crônica ou aguda, como a SBG, no período de janeiro de 2021 a dezembro de 2023, levando em questão aspectos como sexo biológico, idade, etnia, possível etiologia, resposta a imunoglobulina e prognóstico. MÉTODOS: Estudo transversal (cross- sectional), observacional, quantitativo, retrospectivo, baseado em coleta de prontuários de pacientes atendidos no setor de Neurologia do Hospital Universitário Evangélico Mackenzie, em Curitiba-PR, diagnosticados com polineurite inflamatória, e estavam internados no hospital entre o período de 01 de janeiro de 2021 a 31 de dezembro de 2023. RESULTADOS: Foram incluídos na pesquisa 59 pacientes: 30 do sexo masculino e 29 do sexo feminino, com idade média de 59,4 anos, predominantemente de etnia/cor branca. 30 apresentaram prejuízo motor e sensiitivo conjuntamente, 14 somente sensitivo e 15 exclusivamente motor. A contagem de líquor, nos casos onde foi solicitada, demonstrou valor elevado em 83,3%. Quanto à cronicidade, 94,9% foram classificados em PIC (crônica), e 5% em SGB (aguda). 16 dos pacientes retornaram ao Hospital para novo atendimento. Foi realizada corticoterapia em 22% dos pacientes. Imunoglobulina foi administrada em 21 pacientes, e Gabapentina ou Pregabalina em 30. CONCLUSÃO: De forma geral, as distribuições de idade, etnia/cor, sintomatologia sensitiva/motora, e medida proteica no líquor acompanharam a proporção. Também foram obtidas informações a respeito do número de retornos, e escolhas terapêuticas com imunoglobulina, corticoides e analgesia com análogos GABA.
INTRODUCTION: Polyneuritis, including Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Guillain-Barré (GBS), typically presents with bilateral and symmetrical limb weakness, along with diminished or absent deep tendon reflexes. The condition is more common in men. Although the diagnosis is primarily clinical, cerebrospinal fluid analysis showing albuminocytologic dissociation and electrophysiological studies can aid in diagnosis and in differentiating between axonal and demyelinating types. Therapeutic methods include plasmapheresis and intravenous human immunoglobulin, with corticosteroids being used in some cases. OBJECTIVES: The study aims to gather epidemiological data on patients admitted to Hospital Evangélico Mackenzie, who were diagnosed with inflammatory polyradiculoneuropathies, either in their chronic or acute forms, such as GBS, from January 2021 to December 2023, focusing on aspects such as biological sex, age, ethnicity, possible etiology, response to immunoglobulin, and prognosis. METHODS: This is a cross-sectional, observational, quantitative, and retrospective study based on the review of medical records of patients diagnosed with inflammatory polyradiculoneuropathy and admitted to the Neurology Department of Hospital Universitário Evangélico Mackenzie in Curitiba, Paraná, Brazil, between January 1, 2021, and December 31, 2023. RESULTS: The study included 59 patients: 30 males and 29 females, with a mean age of 59.4 years, predominantly of white ethnicity. Thirty patients presented both motor and sensory deficits, 14 had only sensory deficits, and 15 had exclusively motor deficits. Elevated cerebrospinal fluid protein levels were observed in 83.3% of the cases where it was tested. Regarding chronicity, 94.9% were classified as CIDP (chronic), and 5% as GBS (acute). Sixteen patients required readmission. Corticosteroid therapy was administered to 22% of the patients, immunoglobulin was given to 21 patients, and 30 received either Gabapentin or Pregabalin. CONCLUSION: Overall, the distributions of age, ethnicity, sensory/motor symptoms, and protein levels in the cerebrospinal fluid were consistent with expected proportions. Additional data were obtained regarding the frequency of readmissions and the therapeutic choices involving immunoglobulin, corticosteroids, and analgesia with GABA analogs.
INTRODUCTION: Polyneuritis, including Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Guillain-Barré (GBS), typically presents with bilateral and symmetrical limb weakness, along with diminished or absent deep tendon reflexes. The condition is more common in men. Although the diagnosis is primarily clinical, cerebrospinal fluid analysis showing albuminocytologic dissociation and electrophysiological studies can aid in diagnosis and in differentiating between axonal and demyelinating types. Therapeutic methods include plasmapheresis and intravenous human immunoglobulin, with corticosteroids being used in some cases. OBJECTIVES: The study aims to gather epidemiological data on patients admitted to Hospital Evangélico Mackenzie, who were diagnosed with inflammatory polyradiculoneuropathies, either in their chronic or acute forms, such as GBS, from January 2021 to December 2023, focusing on aspects such as biological sex, age, ethnicity, possible etiology, response to immunoglobulin, and prognosis. METHODS: This is a cross-sectional, observational, quantitative, and retrospective study based on the review of medical records of patients diagnosed with inflammatory polyradiculoneuropathy and admitted to the Neurology Department of Hospital Universitário Evangélico Mackenzie in Curitiba, Paraná, Brazil, between January 1, 2021, and December 31, 2023. RESULTS: The study included 59 patients: 30 males and 29 females, with a mean age of 59.4 years, predominantly of white ethnicity. Thirty patients presented both motor and sensory deficits, 14 had only sensory deficits, and 15 had exclusively motor deficits. Elevated cerebrospinal fluid protein levels were observed in 83.3% of the cases where it was tested. Regarding chronicity, 94.9% were classified as CIDP (chronic), and 5% as GBS (acute). Sixteen patients required readmission. Corticosteroid therapy was administered to 22% of the patients, immunoglobulin was given to 21 patients, and 30 received either Gabapentin or Pregabalin. CONCLUSION: Overall, the distributions of age, ethnicity, sensory/motor symptoms, and protein levels in the cerebrospinal fluid were consistent with expected proportions. Additional data were obtained regarding the frequency of readmissions and the therapeutic choices involving immunoglobulin, corticosteroids, and analgesia with GABA analogs.
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polineuropatias , Síndrome de Guillain-Barré , epidemiologia , polyneuropathies , Guillain-Barré Syndrome , epidemiology