Making diagnosis of
chronic inflammatory demyelinating polyradiculoneuropathy (
CIDP) is challenging since it can mimic a multitude of disorders, and is misdiagnosed in at least 50% of cases. We sought to determine the frequency of
CIDP misdiagnosis in clinical practice in Serbia, to uncover
CIDP mimics, and to identify factors that may aid in
CIDP diagnosis. Our longitudinal retrospective cohort study included 86 eligible adult patients referred to the Neurology Clinic, University Clinical Centre of Serbia, with a diagnosis of
CIDP. We also included 15 patients referred to us with different diagnoses that ended up having
CIDP as their final diagnosis. Exactly half of patients referred as
CIDP failed to meet the established diagnostic criteria (non-
CIDP) and were given an alternative diagnosis at the first hospitalization. At the 1-year follow-up, the diagnosis was further revised in four subjects. Confirmed
CIDP patients usually had their initial diagnosis based on the nerve conduction studies (NCS), a typical presentation with symmetrical involvement of all four limbs, as well as higher frequencies of elevated
protein levels and albuminocytologic dissociation in the cerebrospinal fluid (CSF).
CIDP patients also responded better to immune
therapy. We found that 52% of the patients initially referred to our Clinic as
CIDP were given other diagnoses after a 1-year follow-up. Out of all
CIDP cases, 27% had been unrecognized prior to referral to our Center. Utilization of clear and objective indicators - conclusive NCS, improvement on
therapy, and elevated CSF
proteins may provide greater certainty in diagnosing
CIDP.