Author: "Katzberg, Hans" / Database: OAIster - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Katzberg, Hans"' showing total 25 results

Start Over Author "Katzberg, Hans" Database OAIster

25 results on '"Katzberg, Hans"'

1. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Author: Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud‐Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi‐Chao, Chavada, Govind, Dillmann, Klaus‐Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutiérrez‐Gutiérrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., Cornblath, David R., Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud‐Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi‐Chao, Chavada, Govind, Dillmann, Klaus‐Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutiérrez‐Gutiérrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., and Cornblath, David R.
Abstract: Background and purpose: Various electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Published: 2024

2. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Author: Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud‐Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi‐Chao, Chavada, Govind, Dillmann, Klaus‐Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutiérrez‐Gutiérrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., Cornblath, David R., Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud‐Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi‐Chao, Chavada, Govind, Dillmann, Klaus‐Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutiérrez‐Gutiérrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., and Cornblath, David R.
Abstract: Background and purpose: Various electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Published: 2024

3. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

Author: Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud-Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi-Chao, Chavada, Govind, Dillmann, Klaus-Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutierrez-Gutierrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., Cornblath, David R., Arends, Samuel, Drenthen, Judith, de Koning, Laura, van den Bergh, Peter, Hadden, Robert D. M., Kuwabara, Satoshi, Reisin, Ricardo C., Shahrizaila, Nortina, Ajroud-Driss, Senda, Antonini, Giovanni, Attarian, Shahram, Balducci, Claudia, Bertorini, Tulio, Brannagan, Thomas H., Cavaletti, Guido, Chao, Chi-Chao, Chavada, Govind, Dillmann, Klaus-Ulrich, Dimachkie, Mazen M., Galassi, Giuliana, Gutierrez-Gutierrez, Gerardo, Harbo, Thomas, Islam, Badrul, Islam, Zhahirul, Katzberg, Hans, Kusunoki, Susumu, Manganelli, Fiore, Miller, James A. L., Pardo, Julio, Pereon, Yann, Rajabally, Yusuf A., Sindrup, Soren, Stettner, Mark, Uncini, Antonino, Verhamme, Camiel, Vytopil, Michal, Waheed, Waqar, Jacobs, Bart C., and Cornblath, David R.
Abstract: Background and purpose: Various electrodiagnostic criteria have been developed in Guillain–Barré syndrome (GBS). Their performance in a broad representation of GBS patients has not been evaluated. Motor conduction data from the International GBS Outcome Study (IGOS) cohort were used to compare two widely used criterion sets and relate these to diagnostic amyotrophic lateral sclerosis criteria. Methods: From the first 1500 patients in IGOS, nerve conduction studies from 1137 (75.8%) were available for the current study. These patients were classified according to nerve conduction studies criteria proposed by Hadden and Rajabally. Results: Of the 1137 studies, 68.3% (N = 777) were classified identically according to criteria by Hadden and Rajabally: 111 (9.8%) axonal, 366 (32.2%) demyelinating, 195 (17.2%) equivocal, 35 (3.1%) inexcitable and 70 (6.2%) normal. Thus, 360 studies (31.7%) were classified differently. The areas of differences were as follows: 155 studies (13.6%) classified as demyelinating by Hadden and axonal by Rajabally; 122 studies (10.7%) classified as demyelinating by Hadden and equivocal by Rajabally; and 75 studies (6.6%) classified as equivocal by Hadden and axonal by Rajabally. Due to more strictly defined cutoffs fewer patients fulfilled demyelinating criteria by Rajabally than by Hadden, making more patients eligible for axonal or equivocal classification by Rajabally. In 234 (68.6%) axonal studies by Rajabally the revised El Escorial (amyotrophic lateral sclerosis) criteria were fulfilled; in axonal cases by Hadden this was 1.8%. Conclusions and discussion: This study shows that electrodiagnosis in GBS is dependent on the criterion set utilized, both of which are based on expert opinion. Reappraisal of electrodiagnostic subtyping in GBS is warranted.
Published: 2024

4. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Author: Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, van Gorp, Eric C.M., Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, and van Gorp, Eric C.M.
Abstract: Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
Published: 2023

5. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Author: van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, Maria Santibañez-Copado, Ana, van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, and Maria Santibañez-Copado, Ana
Abstract: Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
Published: 2023

6. Safety and Tolerability of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy:Results of the ProCID Study

Author: Cornblath, David R., van Doorn, Pieter A., Hartung, Hans Peter, Merkies, Ingemar S.J., Katzberg, Hans D., Hinterberger, Doris, Clodi, Elisabeth, Cornblath, David R., van Doorn, Pieter A., Hartung, Hans Peter, Merkies, Ingemar S.J., Katzberg, Hans D., Hinterberger, Doris, and Clodi, Elisabeth
Abstract: Background and Aims: The ProCID study evaluated the efficacy and safety of three doses of a 10% liquid intravenous immunoglobulin (IVIg) preparation (panzyga®) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). This report describes the safety findings. Methods: Patients were randomised to receive a 2.0 g/kg induction dose followed by maintenance doses of either 0.5, 1.0 or 2.0 g/kg IVIg every 3 weeks over 24 weeks. Results:All 142 enrolled patients were included in the safety analyses. In total, 286 treatment-emergent adverse events (TEAEs) were reported in 89 patients, of which 173 (60.5%) were considered treatment-related. Most TEAEs were of mild severity. Eleven serious TEAEs were reported in 6 patients. Two serious TEAEs in one patient (headache and vomiting) were considered related to treatment, which resolved without study discontinuation. No treatment-related thrombotic events, haemolytic transfusion reactions or deaths occurred. One patient discontinued the study due to a TEAE (allergic dermatitis) probably related to IVIg. Headache was the only dose-dependent TEAE, with incidences ranging from 2.9 to 23.7%, the incidence of all other TEAEs was similar across treatment groups. Most TEAEs were associated with the induction dose infusion, and the rate of TEAEs decreased thereafter. The median (IQR) daily IVIg dose was 78 (64–90) g, and 94.4% of patients tolerated the maximal infusion rate of 0.12 ml/kg/min without pre-medication. Interpretation:Infusions of 10% IVIg at doses up to 2.0 g/kg with high infusion rates were safe and well tolerated in patients with CIDP. Clinical trial numbers: EudraCT 2015-005443-14, NCT02638207.
Published: 2023

7. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
Full Text: View/download PDF

8. Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase

Author: Van De Munckhof, Anita, Lindgren, Erik, Kleinig, Timothy J., Field, Thalia S., Cordonnier, Charlotte, Krzywicka, Katarzyna, Poli, Sven, Sánchez Van Kammen, Mayte, Borhani-Haghighi, Afshin, Lemmens, Robin, Scutelnic, Adrian, Ciccone, Alfonso, Gattringer, Thomas, Wittstock, Matthias, Dizonno, Vanessa, Devroye, Annemie, Elkady, Ahmed, Günther, Albrecht, Cervera, Alvaro, Mengel, Annerose, Chew, Beng Lim Alvin, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Jacobi, Christian, Soriano, Cristina, Michalski, Dominik, Zamani, Zohreh, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Vuillier, Fabrice, Bode, Felix J., Caparros, François, Maier, Frank, Tsivgoulis, Georgios, Katzberg, Hans D., Duan, Jiangang, Burrow, Jim, Pelz, Johann, Mbroh, Joshua, Oen, Joyce, Schouten, Judith, Zimmermann, Julian, Ng, Karl, Garambois, Katia, Petruzzellis, Marco, Carvalho Dias, Mariana, Ghiasian, Masoud, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Skjelland, Mona, Almasi-Dooghaee, Mostafa, Cuisenier, Pauline, Murphy, Seán, Timsit, Serge, Coutts, Shelagh B., Schönenberger, Silvia, Nagel, Simon, Hiltunen, Sini, Chatterton, Sophie, Cox, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Mirzaasgari, Zahra, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, Aguiar De Sousa, Diana, Ferro, José M., Coutinho, Jonathan M., Van De Munckhof, Anita, Lindgren, Erik, Kleinig, Timothy J., Field, Thalia S., Cordonnier, Charlotte, Krzywicka, Katarzyna, Poli, Sven, Sánchez Van Kammen, Mayte, Borhani-Haghighi, Afshin, Lemmens, Robin, Scutelnic, Adrian, Ciccone, Alfonso, Gattringer, Thomas, Wittstock, Matthias, Dizonno, Vanessa, Devroye, Annemie, Elkady, Ahmed, Günther, Albrecht, Cervera, Alvaro, Mengel, Annerose, Chew, Beng Lim Alvin, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Jacobi, Christian, Soriano, Cristina, Michalski, Dominik, Zamani, Zohreh, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Vuillier, Fabrice, Bode, Felix J., Caparros, François, Maier, Frank, Tsivgoulis, Georgios, Katzberg, Hans D., Duan, Jiangang, Burrow, Jim, Pelz, Johann, Mbroh, Joshua, Oen, Joyce, Schouten, Judith, Zimmermann, Julian, Ng, Karl, Garambois, Katia, Petruzzellis, Marco, Carvalho Dias, Mariana, Ghiasian, Masoud, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Skjelland, Mona, Almasi-Dooghaee, Mostafa, Cuisenier, Pauline, Murphy, Seán, Timsit, Serge, Coutts, Shelagh B., Schönenberger, Silvia, Nagel, Simon, Hiltunen, Sini, Chatterton, Sophie, Cox, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Mirzaasgari, Zahra, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, Aguiar De Sousa, Diana, Ferro, José M., and Coutinho, Jonathan M.
Abstract: Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.
Published: 2022
Full Text: View/download PDF

9. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
Full Text: View/download PDF

10. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
Full Text: View/download PDF

11. An International Perspective on Preceding Infections in Guillain-Barre Syndrome The IGOS-1000 Cohort

Author: Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Burmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., de la Cour, Charlotte Dornonville, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D. M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob, V, Holt, James K. L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W. G., Kuwabara, Satoshi, Pan, Edward Lee, Lehmann, Helmar C., Maas, Marijke, Martin-Aguilar, Lorena, Al Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Soren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Tous, Maria J. Sedano, Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J., Jacobs, Bart C., Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Burmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., de la Cour, Charlotte Dornonville, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D. M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob, V, Holt, James K. L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W. G., Kuwabara, Satoshi, Pan, Edward Lee, Lehmann, Helmar C., Maas, Marijke, Martin-Aguilar, Lorena, Al Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Soren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Tous, Maria J. Sedano, Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J., and Jacobs, Bart C.
Abstract: Background and Objectives Infections play a key role in the development of Guillain-Barre syndrome (GBS) and have been associated with specific clinical features and disease severity. The clinical variation of GBS across geographical regions has been suggested to be related to differences in the distribution of preceding infections, but this has not been studied on a large scale. Methods We analyzed the first 1,000 patients included in the International GBS Outcome Study with available biosamples (n = 768) for the presence of a recent infection with Campylobacter jejuni, hepatitis E virus, Mycoplasma pneumoniae, cytomegalovirus, and Epstein-Barr virus. Results Serologic evidence of a recent infection with C. jejuni was found in 228 (30%), M. pneumoniae in 77 (10%), hepatitis E virus in 23 (3%), cytomegalovirus in 30 (4%), and Epstein-Barr virus in 7 (1%) patients. Evidence of more than 1 recent infection was found in 49 (6%) of these patients. Symptoms of antecedent infections were reported in 556 patients (72%), and this proportion did not significantly differ between those testing positive or negative for a recent infection. The proportions of infections were similar across continents. The sensorimotor variant and the demyelinating electrophysiologic subtype were most frequent across all infection groups, although proportions were significantly higher in patients with a cytomegalovirus and significantly lower in those with a C. jejuni infection. C. jejuni-positive patients were more severely affected, indicated by a lower Medical Research Council sum score at nadir (p = 0.004) and a longer time to regain the ability to walk independently (p = 0.005). The pure motor variant and axonal electrophysiologic subtype were more frequent in Asian compared with American or European C. jejuni-positive patients (p < 0.001, resp. p = 0.001). Time to nadir was longer in the cytomegalovirus-positive patients (p = 0.004). Discussion Across geographical regions, the distribution o
Published: 2022

12. Electrodiagnostic subtyping in Guillain-Barre syndrome: Use of criteria in practice based on a survey study in IGOS

Author: Arends, Samuel, Drenthen, Judith, van den Bergh, Peter Y. K., Hadden, Robert D. M., Shahrizaila, Nortina, Dimachkie, Mazen M., Gutierrez Gutierrez, Gerardo, Katzberg, Hans, Kiers, Lynette, Lehmann, Helmar C., Pereon, Yann, Reisin, Ricardo C., Uncini, Antonino, Verhamme, Camiel, Waheed, Wagar, Cornblath, David R., Jacobs, Bart C., Arends, Samuel, Drenthen, Judith, van den Bergh, Peter Y. K., Hadden, Robert D. M., Shahrizaila, Nortina, Dimachkie, Mazen M., Gutierrez Gutierrez, Gerardo, Katzberg, Hans, Kiers, Lynette, Lehmann, Helmar C., Pereon, Yann, Reisin, Ricardo C., Uncini, Antonino, Verhamme, Camiel, Waheed, Wagar, Cornblath, David R., and Jacobs, Bart C.
Abstract: Electrodiagnostic (EDx) studies are helpful in diagnosing and subtyping of Guillain-Barre syndrome (GBS). Published criteria for differentiation into GBS subtypes focus on cutoff values, but other items receive less attention, although they may influence EDx subtyping: (a) extensiveness of EDx testing, (b) nerve-specific considerations, (c) distal compound muscle action potential (CMAP)-amplitude requirements, (d) criteria for conduction block and temporal dispersion. The aims of this study were to investigate how these aspects were approached by neuromuscular EDx experts in practice and how this was done in previously published EDx criteria for GBS. A completed questionnaire was returned by 24 (of 49) members of the electrophysiology expertise group from the International GBS Outcome Study. Six published EDx criteria for GBS subtyping were compared regarding these aspects. The indicated minimal number of motor nerves to study varied among respondents and tended to be more extensive in equivocal than normal studies. Respondents varied considerably regarding usage of compression sites for subtyping (median/wrist, ulnar/elbow, peroneal/fibular head): 29% used all variables from all sites, 13% excluded all sites, and 58% used only some sites and/or variables. Thirty-eight percent of respondents required a minimal distal CMAP amplitude to classify distal motor latency as demyelinating, and 58% did for motor conduction velocity. For proximal/distal CMAP-amplitude ratio and F-wave latency, a requisite minimal CMAP amplitude was more often required (79%). Also, the various published criteria sets showed differences on all items. Practical use of EDx criteria for subtyping GBS vary extensively across respondents, potentially lowering the reproducibility of GBS subtyping.
Published: 2022

13. Predicting Outcome in Guillain-Barre Syndrome International Validation of the Modified Erasmus GBS Outcome Score

Author: Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A. L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Burmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Tous, Maria J. Sedano, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutierrez-Gutierrez, Gerardo, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip, Wirtz, Paul W., Samijn, Johnny P. A., Gilhuis, H. Jacobus, Hadden, Robert D. M., Holt, James K. L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P. J., Straathof, Chiara S. M., Gorson, Kenneth C., Jacobs, Bart C., Doets, Alex Y., Lingsma, Hester F., Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Kusunoki, Susumu, Dimachkie, Mazen M., Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H., Chavada, Govindsinh, Willison, Hugh J., Casasnovas, Carlos, Bateman, Kathleen, Miller, James A. L., van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E., Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A., Shahrizaila, Nortina, Galassi, Giuliana, Pereon, Yann, Burmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P., Marchesoni, Cintia, Tous, Maria J. Sedano, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H., Lehmann, Helmar C., Granit, Volkan, Cavaletti, Guido, Gutierrez-Gutierrez, Gerardo, Barroso, Fabio A., Visser, Leo H., Katzberg, Hans D., Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J., Eftimov, Filip, Wirtz, Paul W., Samijn, Johnny P. A., Gilhuis, H. Jacobus, Hadden, Robert D. M., Holt, James K. L., Sheikh, Kazim A., Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E., Faber, Catharina G., Gijsbers, Cees J., Busby, Mark, Roberts, Rhys C., Silvestri, Nicholas J., Fazio, Raffaella, van Dijk, Gert W., Garssen, Marcel P. J., Straathof, Chiara S. M., Gorson, Kenneth C., and Jacobs, Bart C.
Abstract: Background and Objectives The clinical course and outcome of the Guillain-Barre syndrome (GBS) are diverse and vary among regions. The modified Erasmus GBS Outcome Score (mEGOS), developed with data from Dutch patients, is a clinical model that predicts the risk of walking inability in patients with GBS. The study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to improve its performance and region specificity. Methods We used prospective data from the first 1,500 patients included in IGOS, aged >= 6 years and unable to walk independently. We evaluated whether the mEGOS at entry and week 1 could predict the inability to walk unaided at 4 and 26 weeks in the full cohort and in regional subgroups, using 2 measures for model performance: (1) discrimination: area under the receiver operating characteristic curve (AUC) and (2) calibration: observed vs predicted probability of being unable to walk independently. To improve the model predictions, we recalibrated the model containing the overall mEGOS score, without changing the individual predictive factors. Finally, we assessed the predictive ability of the individual factors. Results For validation of mEGOS at entry, 809 patients were eligible (Europe/North America [n = 677], Asia [n = 76], other [n = 56]), and 671 for validation of mEGOS at week 1 (Europe/North America [n = 563], Asia [n = 65], other [n = 43]). AUC values were >0.7 in all regional subgroups. In the Europe/North America subgroup, observed outcomes were worse than predicted; in Asia, observed outcomes were better than predicted. Recalibration improved model accuracy and enabled the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). Similar to the original mEGOS, severe limb weakness and higher age were the predominant predictors of poor outcome in the IGOS cohort. Discussion mEGOS is a validated tool to predict the inability to walk unaided at 4 and 26 weeks in patients with GBS, a
Published: 2022

14. Randomized trial of three IVIg doses for treating chronic inflammatory demyelinating polyneuropathy

Author: Cornblath, David R., Van Doorn, Pieter A., Hartung, Hans Peter, Merkies, Ingemar S.J., Katzberg, Hans D., Hinterberger, Doris, Clodi, Elisabeth, Cornblath, David R., Van Doorn, Pieter A., Hartung, Hans Peter, Merkies, Ingemar S.J., Katzberg, Hans D., Hinterberger, Doris, and Clodi, Elisabeth
Abstract: Intravenous immunoglobulin treatment for chronic inflammatory demyelinating polyneuropathy usually starts with a 2.0 g/kg induction dose followed by 1.0 g/kg maintenance doses every 3 weeks. No dose-ranging studies with intravenous immunoglobulin maintenance therapy have been published. The Progress in Chronic Inflammatory Demyelinating polyneuropathy (ProCID) study was a prospective, double-blind, randomized, parallel-group, multicentre, phase III study investigating the efficacy and safety of 10% liquid intravenous immunoglobulin (Panzyga®) in patients with active chronic inflammatory demyelinating polyneuropathy. Patients were randomized 1:2:1 to receive the standard intravenous immunoglobulin induction dose and then either 0.5, 1.0 or 2.0 g/kg maintenance doses every 3 weeks. The primary end point was the response rate in the 1.0 g/kg group, defined as an improvement ≥1 point in adjusted Inflammatory Neuropathy Cause and Treatment score at Week 6 versus baseline and maintained at Week 24. Secondary end points included dose response and safety. This trial was registered with EudraCT (Number 2015-005443-14) and clinicaltrials.gov (NCT02638207). Between August 2017 and September 2019, the study enrolled 142 patients. All 142 were included in the safety analyses. As no post-infusion data were available for three patients, 139 were included in the efficacy analyses, of whom 121 were previously on corticosteroids. The response rate was 80% (55/69 patients) [95% confidence interval (CI): 69-88%] in the 1.0 g/kg group, 65% (22/34; CI: 48-79%) in the 0.5 g/kg group, and 92% (33/36; CI: 78-97%) in the 2.0 g/kg group. While the proportion of responders was higher with higher maintenance doses, logistic regression analysis showed that the effect on response rate was driven by a significant difference between the 0.5 and 2.0 g/kg groups, whereas the response rates in the 0.5 and 2.0 g/kg groups did not differ significantly from the 1.0 g/kg group. Fifty-six per cent of al
Published: 2022

15. Electrodiagnostic subtyping in Guillain-Barré syndrome:Use of criteria in practice based on a survey study in IGOS

Author: Arends, Samuel, Drenthen, Judith, Van den Bergh, Peter Y.K., Hadden, Robert D.M., Shahrizaila, Nortina, Dimachkie, Mazen M., Gutiérrez Gutiérrez, Gerardo, Katzberg, Hans, Kiers, Lynette, Lehmann, Helmar C., Péréon, Yann, Reisin, Ricardo C., Uncini, Antonino, Verhamme, Camiel, Waheed, Wagar, Cornblath, David R., Jacobs, Bart C., Arends, Samuel, Drenthen, Judith, Van den Bergh, Peter Y.K., Hadden, Robert D.M., Shahrizaila, Nortina, Dimachkie, Mazen M., Gutiérrez Gutiérrez, Gerardo, Katzberg, Hans, Kiers, Lynette, Lehmann, Helmar C., Péréon, Yann, Reisin, Ricardo C., Uncini, Antonino, Verhamme, Camiel, Waheed, Wagar, Cornblath, David R., and Jacobs, Bart C.
Abstract: Electrodiagnostic (EDx) studies are helpful in diagnosing and subtyping of Guillain-Barré syndrome (GBS). Published criteria for differentiation into GBS subtypes focus on cutoff values, but other items receive less attention, although they may influence EDx subtyping: (a) extensiveness of EDx testing, (b) nerve-specific considerations, (c) distal compound muscle action potential (CMAP)-amplitude requirements, (d) criteria for conduction block and temporal dispersion. The aims of this study were to investigate how these aspects were approached by neuromuscular EDx experts in practice and how this was done in previously published EDx criteria for GBS. A completed questionnaire was returned by 24 (of 49) members of the electrophysiology expertise group from the International GBS Outcome Study. Six published EDx criteria for GBS subtyping were compared regarding these aspects. The indicated minimal number of motor nerves to study varied among respondents and tended to be more extensive in equivocal than normal studies. Respondents varied considerably regarding usage of compression sites for subtyping (median/wrist, ulnar/elbow, peroneal/fibular head): 29% used all variables from all sites, 13% excluded all sites, and 58% used only some sites and/or variables. Thirty-eight percent of respondents required a minimal distal CMAP amplitude to classify distal motor latency as demyelinating, and 58% did for motor conduction velocity. For proximal/distal CMAP-amplitude ratio and F-wave latency, a requisite minimal CMAP amplitude was more often required (79%). Also, the various published criteria sets showed differences on all items. Practical use of EDx criteria for subtyping GBS vary extensively across respondents, potentially lowering the reproducibility of GBS subtyping.
Published: 2022

16. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C.M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J.H.A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C.M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J.H.A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing
Published: 2022

17. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
Full Text: View/download PDF

18. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
Full Text: View/download PDF

19. Predicting Outcome in Guillain-Barré Syndrome: International Validation of the Modified Erasmus GBS Outcome Score

Author: Doets, A, Lingsma, H, Walgaard, C, Islam, B, Papri, N, Davidson, A, Yamagishi, Y, Kusunoki, S, Dimachkie, M, Waheed, W, Kolb, N, Islam, Z, Mohammad, Q, Harbo, T, Sindrup, S, Chavada, G, Willison, H, Casasnovas, C, Bateman, K, Miller, J, van den Berg, B, Verboon, C, Roodbol, J, Leonhard, S, Benedetti, L, Kuwabara, S, Van den Bergh, P, Monges, S, Marfia, G, Shahrizaila, N, Galassi, G, Péréon, Y, Bürmann, J, Kuitwaard, K, Kleyweg, R, Marchesoni, C, Sedano Tous, M, Querol, L, Illa, I, Wang, Y, Nobile-Orazio, E, Rinaldi, S, Schenone, A, Pardo, J, Vermeij, F, Lehmann, H, Granit, V, Cavaletti, G, Gutiérrez-Gutiérrez, G, Barroso, F, Visser, L, Katzberg, H, Dardiotis, E, Attarian, S, van der Kooi, A, Eftimov, F, Wirtz, P, Samijn, J, Gilhuis, H, Hadden, R, Holt, J, Sheikh, K, Karafiath, S, Vytopil, M, Antonini, G, Feasby, T, Faber, C, Gijsbers, C, Busby, M, Roberts, R, Silvestri, N, Fazio, R, van Dijk, G, Garssen, M, Straathof, C, Gorson, K, Jacobs, B, Doets, Alex Y, Lingsma, Hester F, Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M, Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H, Chavada, Govindsinh, Willison, Hugh J, Casasnovas, Carlos, Bateman, Kathleen, Miller, James A L, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Lehmann, Helmar C, Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A, Visser, Leo H, Katzberg, Hans D, Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J, Eftimov, Filip, Wirtz, Paul W, Samijn, Johnny P A, Gilhuis, H Jacobus, Hadden, Robert D M, Holt, James K L, Sheikh, Kazim A, Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E, Faber, Catharina G, Gijsbers, Cees J, Busby, Mark, Roberts, Rhys C, Silvestri, Nicholas J, Fazio, Raffaella, van Dijk, Gert W, Garssen, Marcel P J, Straathof, Chiara S M, Gorson, Kenneth C, Jacobs, Bart C, Doets, A, Lingsma, H, Walgaard, C, Islam, B, Papri, N, Davidson, A, Yamagishi, Y, Kusunoki, S, Dimachkie, M, Waheed, W, Kolb, N, Islam, Z, Mohammad, Q, Harbo, T, Sindrup, S, Chavada, G, Willison, H, Casasnovas, C, Bateman, K, Miller, J, van den Berg, B, Verboon, C, Roodbol, J, Leonhard, S, Benedetti, L, Kuwabara, S, Van den Bergh, P, Monges, S, Marfia, G, Shahrizaila, N, Galassi, G, Péréon, Y, Bürmann, J, Kuitwaard, K, Kleyweg, R, Marchesoni, C, Sedano Tous, M, Querol, L, Illa, I, Wang, Y, Nobile-Orazio, E, Rinaldi, S, Schenone, A, Pardo, J, Vermeij, F, Lehmann, H, Granit, V, Cavaletti, G, Gutiérrez-Gutiérrez, G, Barroso, F, Visser, L, Katzberg, H, Dardiotis, E, Attarian, S, van der Kooi, A, Eftimov, F, Wirtz, P, Samijn, J, Gilhuis, H, Hadden, R, Holt, J, Sheikh, K, Karafiath, S, Vytopil, M, Antonini, G, Feasby, T, Faber, C, Gijsbers, C, Busby, M, Roberts, R, Silvestri, N, Fazio, R, van Dijk, G, Garssen, M, Straathof, C, Gorson, K, Jacobs, B, Doets, Alex Y, Lingsma, Hester F, Walgaard, Christa, Islam, Badrul, Papri, Nowshin, Davidson, Amy, Yamagishi, Yuko, Kusunoki, Susumu, Dimachkie, Mazen M, Waheed, Waqar, Kolb, Noah, Islam, Zhahirul, Mohammad, Quazi Deen, Harbo, Thomas, Sindrup, Soren H, Chavada, Govindsinh, Willison, Hugh J, Casasnovas, Carlos, Bateman, Kathleen, Miller, James A L, van den Berg, Bianca, Verboon, Christine, Roodbol, Joyce, Leonhard, Sonja E, Benedetti, Luana, Kuwabara, Satoshi, Van den Bergh, Peter, Monges, Soledad, Marfia, Girolama A, Shahrizaila, Nortina, Galassi, Giuliana, Péréon, Yann, Bürmann, Jan, Kuitwaard, Krista, Kleyweg, Ruud P, Marchesoni, Cintia, Sedano Tous, María J, Querol, Luis, Illa, Isabel, Wang, Yuzhong, Nobile-Orazio, Eduardo, Rinaldi, Simon, Schenone, Angelo, Pardo, Julio, Vermeij, Frederique H, Lehmann, Helmar C, Granit, Volkan, Cavaletti, Guido, Gutiérrez-Gutiérrez, Gerardo, Barroso, Fabio A, Visser, Leo H, Katzberg, Hans D, Dardiotis, Efthimios, Attarian, Shahram, van der Kooi, Anneke J, Eftimov, Filip, Wirtz, Paul W, Samijn, Johnny P A, Gilhuis, H Jacobus, Hadden, Robert D M, Holt, James K L, Sheikh, Kazim A, Karafiath, Summer, Vytopil, Michal, Antonini, Giovanni, Feasby, Thomas E, Faber, Catharina G, Gijsbers, Cees J, Busby, Mark, Roberts, Rhys C, Silvestri, Nicholas J, Fazio, Raffaella, van Dijk, Gert W, Garssen, Marcel P J, Straathof, Chiara S M, Gorson, Kenneth C, and Jacobs, Bart C
Abstract: Background and objectives: The clinical course and outcome of the Guillain-Barré syndrome (GBS) are diverse and vary among regions. The modified Erasmus GBS Outcome Score (mEGOS), developed with data from Dutch patients, is a clinical model that predicts the risk of walking inability in patients with GBS. The study objective was to validate the mEGOS in the International GBS Outcome Study (IGOS) cohort and to improve its performance and region specificity. Methods: We used prospective data from the first 1,500 patients included in IGOS, aged ≥6 years and unable to walk independently. We evaluated whether the mEGOS at entry and week 1 could predict the inability to walk unaided at 4 and 26 weeks in the full cohort and in regional subgroups, using 2 measures for model performance: (1) discrimination: area under the receiver operating characteristic curve (AUC) and (2) calibration: observed vs predicted probability of being unable to walk independently. To improve the model predictions, we recalibrated the model containing the overall mEGOS score, without changing the individual predictive factors. Finally, we assessed the predictive ability of the individual factors. Results: For validation of mEGOS at entry, 809 patients were eligible (Europe/North America [n = 677], Asia [n = 76], other [n = 56]), and 671 for validation of mEGOS at week 1 (Europe/North America [n = 563], Asia [n = 65], other [n = 43]). AUC values were >0.7 in all regional subgroups. In the Europe/North America subgroup, observed outcomes were worse than predicted; in Asia, observed outcomes were better than predicted. Recalibration improved model accuracy and enabled the development of a region-specific version for Europe/North America (mEGOS-Eu/NA). Similar to the original mEGOS, severe limb weakness and higher age were the predominant predictors of poor outcome in the IGOS cohort. Discussion: mEGOS is a validated tool to predict the inability to walk unaided at 4 and 26 weeks in patients with
Published: 2022

20. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, Arslan, Yildiz, Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, and Arslan, Yildiz
Abstract: Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI
Published: 2021
Full Text: View/download PDF

21. Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay

Author: dos Santos, Claudia, dos Santos, Claudia, Hussain, Sabah N. A., Mathur, Sunita, Picard, Martin, Herridge, Margaret, Correa, Judy, Bain, Alexandra, Guo, Yeting, Advani, Andrew, Advani, Suzanne L., Tomlinson, George, Katzberg, Hans, Streutker, Catherine J., Cameron, Jill I., Schols, Annemie, Gosker, Harry R., Batt, Jane, dos Santos, Claudia, dos Santos, Claudia, Hussain, Sabah N. A., Mathur, Sunita, Picard, Martin, Herridge, Margaret, Correa, Judy, Bain, Alexandra, Guo, Yeting, Advani, Andrew, Advani, Suzanne L., Tomlinson, George, Katzberg, Hans, Streutker, Catherine J., Cameron, Jill I., Schols, Annemie, Gosker, Harry R., and Batt, Jane
Abstract: Rationale: Critical illness survivors often experience permanent functional disability due to intensive care unit (ICU)-acquired weakness. The mechanisms responsible for long-term weakness persistence versus resolution are unknown. Objectives: To delineate cellular mechanisms underlying long-term weakness persistence in ICU survivors. Methods: We conducted a nested, prospective study of critically ill patients mechanically ventilated for 7 days or longer. The patients were recruited from the RECOVER program and serially assessed over 6 months after ICU discharge. Twenty-seven of 82 patients consented to participate; 15 and 11 patients were assessed at 7 days and 6 months after ICU discharge, respectively. Measurements and Main Results: We assessed motor functional capacity, quadriceps size, strength, and voluntary contractile capacity and performed electromyography, nerve conduction studies, and vastus lateralis biopsies for histologic, cellular, and molecular analyses. Strength and quadriceps cross-sectional areas were decreased 7 days after ICU discharge. Weakness persisted to 6 months and correlated with decreased function. Quadriceps atrophy resolved in 27% patients at 6 months. Muscle mass reconstitution did not correlate with resolution of weakness, owing to persistent impaired voluntary contractile capacity. Compared with Day 7, increased ubiquitin proteasome system mediated muscle proteolysis, inflammation, and decreased mitochondrial content all normalized at 6 months. Autophagy markers were normal at 6 months. Patients with sustained atrophy had decreased muscle progenitor (satellite) cell content. Conclusions: Long-term weakness in ICU survivors results from heterogeneous muscle pathophysiology with variable combinations of muscle atrophy and impaired contractile capacity. These findings are not explained by ongoing muscle proteolysis, inflammation, or diminished mitochondrial content. Sustained muscle atrophy is associated with decreased satellite cell c
Published: 2016

22. Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay

Author: dos Santos, Claudia, Hussain, Sabah N. A., Mathur, Sunita, Picard, Martin, Herridge, Margaret, Correa, Judy, Bain, Alexandra, Guo, Yeting, Advani, Andrew, Advani, Suzanne L., Tomlinson, George, Katzberg, Hans, Streutker, Catherine J., Cameron, Jill I., Schols, Annemie, Gosker, Harry R., Batt, Jane, dos Santos, Claudia, Hussain, Sabah N. A., Mathur, Sunita, Picard, Martin, Herridge, Margaret, Correa, Judy, Bain, Alexandra, Guo, Yeting, Advani, Andrew, Advani, Suzanne L., Tomlinson, George, Katzberg, Hans, Streutker, Catherine J., Cameron, Jill I., Schols, Annemie, Gosker, Harry R., and Batt, Jane
Abstract: Rationale: Critical illness survivors often experience permanent functional disability due to intensive care unit (ICU)-acquired weakness. The mechanisms responsible for long-term weakness persistence versus resolution are unknown. Objectives: To delineate cellular mechanisms underlying long-term weakness persistence in ICU survivors. Methods: We conducted a nested, prospective study of critically ill patients mechanically ventilated for 7 days or longer. The patients were recruited from the RECOVER program and serially assessed over 6 months after ICU discharge. Twenty-seven of 82 patients consented to participate; 15 and 11 patients were assessed at 7 days and 6 months after ICU discharge, respectively. Measurements and Main Results: We assessed motor functional capacity, quadriceps size, strength, and voluntary contractile capacity and performed electromyography, nerve conduction studies, and vastus lateralis biopsies for histologic, cellular, and molecular analyses. Strength and quadriceps cross-sectional areas were decreased 7 days after ICU discharge. Weakness persisted to 6 months and correlated with decreased function. Quadriceps atrophy resolved in 27% patients at 6 months. Muscle mass reconstitution did not correlate with resolution of weakness, owing to persistent impaired voluntary contractile capacity. Compared with Day 7, increased ubiquitin proteasome system mediated muscle proteolysis, inflammation, and decreased mitochondrial content all normalized at 6 months. Autophagy markers were normal at 6 months. Patients with sustained atrophy had decreased muscle progenitor (satellite) cell content. Conclusions: Long-term weakness in ICU survivors results from heterogeneous muscle pathophysiology with variable combinations of muscle atrophy and impaired contractile capacity. These findings are not explained by ongoing muscle proteolysis, inflammation, or diminished mitochondrial content. Sustained muscle atrophy is associated with decreased satellite cell c
Published: 2016

23. Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison

Author: UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Vanhoutte, Els K, Draak, Thomas H P, Gorson, Kenneth C, van Nes, Sonja I, Hoeijmakers, Janneke G J, Van der Pol, W-Ludo, Notermans, Nicolette C, Lewis, Richard A, Nobile-Orazio, Eduardo, Léger, Jean-Marc, Van den Bergh, Peter Y K, Lauria, Giuseppe, Bril, Vera, Katzberg, Hans, Lunn, Michael P T, Pouget, Jean, van der Kooi, Anneke J, Hahn, Angelika F, van Doorn, Pieter A, Cornblath, David R, van den Berg, Leonard H, Faber, Catharina G, Merkies, Ingemar S J, PeriNomS Study Group., Van den Bergh, Peter, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Vanhoutte, Els K, Draak, Thomas H P, Gorson, Kenneth C, van Nes, Sonja I, Hoeijmakers, Janneke G J, Van der Pol, W-Ludo, Notermans, Nicolette C, Lewis, Richard A, Nobile-Orazio, Eduardo, Léger, Jean-Marc, Van den Bergh, Peter Y K, Lauria, Giuseppe, Bril, Vera, Katzberg, Hans, Lunn, Michael P T, Pouget, Jean, van der Kooi, Anneke J, Hahn, Angelika F, van Doorn, Pieter A, Cornblath, David R, van den Berg, Leonard H, Faber, Catharina G, Merkies, Ingemar S J, PeriNomS Study Group., and Van den Bergh, Peter
Abstract: This study aimed to 'define responder' through the concept of minimum clinically important differences using the individually obtained standard errors (MCID-SE) and a heuristic 'external criterion' responsiveness method in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). One hundred and fourteen newly diagnosed or relapsing patients (GBS: 55, CIDP: 59) were serially examined (1-year follow-up). The inflammatory Rasch-built overall disability scale (I-RODS), Rasch-transformed MRC sum score (RT-MRC), and Rasch-transformed modified-INCAT-sensory scale (RT-mISS) were assessed. Being-a-responder was defined as having a MCID-SE cut-off ≥1.96. Also, the correlations between patients' scores on each scale and the EuroQoL health-status 'thermometer' (external criterion) were determined (higher correlation indicated better responsiveness). In both diseases, the SEs showed a characteristic 'U'-shaped dynamic pattern across each scales' continuum. The number of patients showing a meaningful change were higher for the I-RODS > RT-MRC > RT-mISS and were in GBS higher than CIDP patients. The MCID-SE concept using Rasch-transformed data demonstrated an individual pattern of 'being-a-responder' in patients with immune-mediated neuropathies, and the findings were validated by the external criterion responsiveness method. The I-RODS showed greater responsiveness compared with the MRC and INCAT-sensory scales, and its use is therefore recommended in future trials in GBS and CIDP.
Published: 2015

24. Changing outcome in inflammatory neuropathies: Rasch-comparative responsiveness

Author: UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Draak, Thomas H P, Vanhoutte, Els K, van Nes, Sonja I, Gorson, Kenneth C, Van der Pol, W Ludo, Notermans, Nicolette C, Nobile-Orazio, Eduardo, Léger, Jean-Marc, Van den Bergh, Peter, Lauria, Giuseppe, Bril, Vera, Katzberg, Hans, Lunn, Michael P T, Pouget, Jean, van der Kooi, Anneke J, Hahn, Angelika F, Doorn, Pieter A van, Cornblath, David R, van den Berg, Leonard H, Faber, Catharina G, Merkies, Ingemar S J, PeriNomS Study Group, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service de neurologie, Draak, Thomas H P, Vanhoutte, Els K, van Nes, Sonja I, Gorson, Kenneth C, Van der Pol, W Ludo, Notermans, Nicolette C, Nobile-Orazio, Eduardo, Léger, Jean-Marc, Van den Bergh, Peter, Lauria, Giuseppe, Bril, Vera, Katzberg, Hans, Lunn, Michael P T, Pouget, Jean, van der Kooi, Anneke J, Hahn, Angelika F, Doorn, Pieter A van, Cornblath, David R, van den Berg, Leonard H, Faber, Catharina G, Merkies, Ingemar S J, and PeriNomS Study Group
Abstract: OBJECTIVES: We performed responsiveness comparison between the patient-reported Inflammatory Rasch-built Overall Disability Scale (I-RODS) and the widely used clinician-reported Inflammatory Neuropathy Cause and Treatment-Overall Neuropathy Limitation Scale (INCAT-ONLS) in patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and immunoglobulin M-monoclonal gammopathy of undetermined significance related polyneuropathy (IgM-MGUSP). METHODS: One hundred thirty-seven patients (GBS: 55, CIDP: 59, IgM-MGUSP: 23) with a new diagnosis or clinical relapse assessed both scales. Patients with GBS/CIDP were examined at 0, 1, 3, 6, and 12 months; patients with IgM-MGUSP at 0, 3, and 12. We subjected all data to Rasch analyses, and calculated for each patient the magnitude of change on both scales using the minimal clinically important difference (MCID) related to the individual standard errors (SEs). A responder was defined as having an MCID-SE ≥1.96. Individual scores on both measures were correlated with the EuroQoL thermometer (heuristic responsiveness). RESULTS: The I-RODS showed a significantly higher proportion of meaningful improvement compared with the INCAT-ONLS findings in GBS/CIDP. For IgM-MGUSP, the lack of responsiveness during the 1-year study did not allow a clear separation. Heuristic responsiveness was consistently higher with the I-RODS. CONCLUSION: The I-RODS more often captures clinically meaningful changes over time, with a greater magnitude of change, compared with the INCAT-ONLS disability scale in patients with GBS and CIDP. The I-RODS offers promise for being a more sensitive measure and its use is therefore suggested in future trials involving patients with GBS and CIDP.
Published: 2014

25. Combined fulminant frontotemporal dementia and amyotrophic lateral sclerosis associated with an I113T SOD1 mutation

Author: Katz, Jonathan S., Katzberg, Hans D., Woolley, Susan C., Marklund, Stefan L., Andersen, Peter M., Katz, Jonathan S., Katzberg, Hans D., Woolley, Susan C., Marklund, Stefan L., and Andersen, Peter M.
Abstract: Mutations in the gene for superoxide dismutase type 1 cause amyotrophic lateral sclerosis (ALS), but are not thought to be associated with frontotemporal dementia (FTD). A lack of detailed case reports is one reason, among others, for this skepticism. This case report comments on a patient with familial ALS caused by I113T mutation in the SOD1 gene presenting with progressive cognitive and behavioral decline two years before developing progressive motor degeneration. In conclusion, this case provides evidence that SOD1 mutations can be associated with FTD.
Published: 2012
Full Text: View/download PDF

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources

Refine your results

25 results on '"Katzberg, Hans"'

1. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

2. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

3. Electrodiagnostic subtyping in Guillain–Barré syndrome patients in the International Guillain–Barré Outcome Study

4. Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

5. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

6. Safety and Tolerability of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy:Results of the ProCID Study

7. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

8. Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase

9. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

10. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

11. An International Perspective on Preceding Infections in Guillain-Barre Syndrome The IGOS-1000 Cohort

12. Electrodiagnostic subtyping in Guillain-Barre syndrome: Use of criteria in practice based on a survey study in IGOS

13. Predicting Outcome in Guillain-Barre Syndrome International Validation of the Modified Erasmus GBS Outcome Score

14. Randomized trial of three IVIg doses for treating chronic inflammatory demyelinating polyneuropathy

15. Electrodiagnostic subtyping in Guillain-Barré syndrome:Use of criteria in practice based on a survey study in IGOS

16. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

17. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

18. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

19. Predicting Outcome in Guillain-Barré Syndrome: International Validation of the Modified Erasmus GBS Outcome Score

20. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

21. Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay

22. Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay

23. Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison

24. Changing outcome in inflammatory neuropathies: Rasch-comparative responsiveness

25. Combined fulminant frontotemporal dementia and amyotrophic lateral sclerosis associated with an I113T SOD1 mutation

Catalog

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Publication Year Range

Publication Type

Database

Publisher

25 results on '"Katzberg, Hans"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources