TY - JOUR
T1 - Neural damage associated with atopic diathesis
T2 - A nationwide survey in japan
AU - Isobe, N.
AU - Kira, J.
AU - Kawamura, N.
AU - Ishizu, T.
AU - Arimura, K.
AU - Kawano, Y.
N1 - Funding Information:
Dr. Isobe, Dr. Kawamura, Dr. Ishizu, and Dr. Kawano report no disclosures. Dr. Kira serves on the editorial board of Multiple Sclerosis , The Open Neurology Journal, and Autoimmune Diseases , serves as on the editorial advisory board of The Year in Neurology , and serves as a journal editor of Rinsho Shinkeigaku ; serves as a consultant for Biogen Idec Japan; received speaker honorarium and funding for travel from Bayer Healthcare; and receives research support from the Ministry of Health, Labour and Welfare, Japan [H14-tokushitsu-16/H14-nanchi-16/H17-nanchi-ippan-016 (Principal Investigator)]. Dr. Arimura has served as a consultant for Takeda Pharmaceutical Company Limited and receives research support from the Ministry of Health, Labour and Welfare, Japan [19-5 (Chief Investigator)].
PY - 2009/9
Y1 - 2009/9
N2 - We previously reported the occurrence of myelitis in patients with atopic disorders (atopic myelitis [AM]). To uncover the spectrum of neural damage associated with atopy, we conducted a cross-sectional nationwide survey of AM and atopy-related peripheral neuritis (APN), including Churg-Strauss syndrome (CSS), in individuals with atopic diathesis. Cases with AM diagnosed between 1996 and 2006 and cases with APN between 2000 and 2006 were collected from all over Japan. Detailed data on 109 patients with AM and 133 patients with APN were collated. Patients with APN showed a preponderance of women, higher age at onset, and greater eosinophil counts than patients with AM. Patients with AM most commonly showed cervical cord involvement, whereas patients with APN preferentially exhibited mononeuritis multiplex predominantly affecting the lower limbs. Among patients with AM, motor weakness and muscle atrophy were significantly more frequent in those with bronchial asthma than in those with other atopic disorders. Patients with APN who met the criteria for CSS showed a higher age at onset, higher frequencies of systemic organ involvement, and greater disability than those who did not. Abnormalities suggesting peripheral nervous system involvement were seen in 25.7% of patients with AM, whereas 18.8% of patients with APN had abnormalities indicating CNS involvement. Multiple logistic regression analyses revealed that atopic dermatitis increased the risk of myelitis, whereas high age at onset and bronchial asthma decreased that risk. Atopy-related neural inflammation multifocally affects CNS and peripheral nervous system tissues. Both preceding atopic disorders and age seem to influence the distribution of neural damage.
AB - We previously reported the occurrence of myelitis in patients with atopic disorders (atopic myelitis [AM]). To uncover the spectrum of neural damage associated with atopy, we conducted a cross-sectional nationwide survey of AM and atopy-related peripheral neuritis (APN), including Churg-Strauss syndrome (CSS), in individuals with atopic diathesis. Cases with AM diagnosed between 1996 and 2006 and cases with APN between 2000 and 2006 were collected from all over Japan. Detailed data on 109 patients with AM and 133 patients with APN were collated. Patients with APN showed a preponderance of women, higher age at onset, and greater eosinophil counts than patients with AM. Patients with AM most commonly showed cervical cord involvement, whereas patients with APN preferentially exhibited mononeuritis multiplex predominantly affecting the lower limbs. Among patients with AM, motor weakness and muscle atrophy were significantly more frequent in those with bronchial asthma than in those with other atopic disorders. Patients with APN who met the criteria for CSS showed a higher age at onset, higher frequencies of systemic organ involvement, and greater disability than those who did not. Abnormalities suggesting peripheral nervous system involvement were seen in 25.7% of patients with AM, whereas 18.8% of patients with APN had abnormalities indicating CNS involvement. Multiple logistic regression analyses revealed that atopic dermatitis increased the risk of myelitis, whereas high age at onset and bronchial asthma decreased that risk. Atopy-related neural inflammation multifocally affects CNS and peripheral nervous system tissues. Both preceding atopic disorders and age seem to influence the distribution of neural damage.
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U2 - 10.1212/WNL.0b013e3181b6bb6b
DO - 10.1212/WNL.0b013e3181b6bb6b
M3 - Article
C2 - 19738174
AN - SCOPUS:70349568504
VL - 73
SP - 790
EP - 797
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 10
ER -