Kortikoidy – lečba prvni volby u CIDP?

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dc.contributor.author Ehler, Edvard cze
dc.date.accessioned 2020-03-19T13:30:57Z
dc.date.available 2020-03-19T13:30:57Z
dc.date.issued 2019 cze
dc.identifier.issn 1213-1814 cze
dc.identifier.uri https://hdl.handle.net/10195/75249
dc.description.abstract Chronicka zanětliva demyelinizačni polyradikuloneuropatie (CIDP) je nejčastějši chronicka autoimunitni neuropatie. V patogenezi CIDP se učastni jak protilatkova, tak i buněčna imunita. Nejčastěji se vyskytuje klasicka forma, ktera se vyznačuje teměř symetrickym klinickym nalezem a multifokalnim postiženim motorickych i senzitivnich vlaken v elektrofyziologicke diagnostice. Terapie CIDP se zahajuje tzv. indukčni lečbou, a to kortikosteroidy, intravenozni aplikaci vysokych davek imunoglobulinů (IVIG) či terapeutickou plazmaferezou (TPF). Vzhledem k narokům na přistrojove vybaveni a častějšim vyskytem nežadoucich reakci u TPF se v praxi použivaji kortikoidy či IVIG pro lečbu prvni volby. IVIG ve srovnani s kortikoidy miva rychlejši a vyraznějši terapeuticky efekt, ktery však trva kratši dobu. Podani IVIG je take podstatně dražši. Nevyhodou dlouhodobe terapie kortikoidy je vyskyt nežadoucich vedlejšich učinků. Podani IVIG je indikovano jako primarni u čistě motorickych forem či forem s převahou postiženi motorickych vlaken, u nemocnych s kontraindikaci kortikoidů a u děti. Kortikosteroidy jsou primarně indikovany jako indukčni terapie u převažne časti nemocnych s CIDP. Intravenozni podani kortikoidů či opakovana bolusova peroralni terapie jsou zatižena nižšim vyskytem nežadoucich vedlejšich učinků ve srovnani s dennim peroralnim podavanim kortikoidů cze
dc.format p. 43-48 cze
dc.language.iso cze cze
dc.relation.ispartof Neurologie pro praxi, volume 20, issue: 1 cze
dc.rights Práce není přístupná cze
dc.subject chronicka zanětliva demyelinizačni polyradikuloneuropatie, imunoglobuliny, terapeuticka plazmafereza, kortikoterapie. cze
dc.subject chronic inflammatory demyelinating polyradiculoneuropathy, immunoglobulins, therapeutic plasma exchange, corticosteroid therapy eng
dc.title Kortikoidy – lečba prvni volby u CIDP? cze
dc.title.alternative Corticosteroids – therapy of the first choice? eng
dc.type article cze
dc.description.abstract-translated Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most frequent autoimmune neuropathy. The processes participating in pathogenesis of CIDP are primarily of humoral and also cellular immunity. In CIDP, the most frequent is classical form, which is characterized by clinically nearly symmetric and electrophysiologically multifocal impairment of motor and sensory fibers. Therapy of CIDP is initiated by „induction therapy“, consisting of corticosteroids, intravenous administration of high doses of immunoglobulins (IVIG) or therapeutic plasma exchange (TPE). In view of the high demands on the equipment and of more frequent adverse reactions in TPE, the use of corticosteroids or IVIG is the therapy of the first choice. In comparison with steroids the administration of IVIG displays quicker and stronger therapeutic effects, but with shorter duration. Administration of IVIG is also noticeably more expensive. The disadvantage of long lasting steroid therapy is the occurrence of adverse effects. Administration of IVIG is indicated as a first treatment in pure motor forms or in forms with prevailing motor impairment, in patients with contraindication of steroids and in children. Intravenous administration of steroids or repeated oral bolus therapy is associated with a lower occurrence of adverse events in comparison with daily oral corticosteroid therapy. eng
dc.peerreviewed yes cze
dc.publicationstatus postprint cze
dc.relation.publisherversion https://www.neurologiepropraxi.cz/pdfs/neu/2019/01/10.pdf cze
dc.identifier.obd 39884410 cze


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