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Sipilä JOT, Soilu-Hänninen M, Ruuskanen JO, Rautava P, Kytö V. Epidemiology of Guillain-Barré syndrome in Finland 2004-2014. J Peripher Nerv Syst 2017; 22:440-445. [PMID: 29095548 PMCID: PMC5765466 DOI: 10.1111/jns.12239] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/21/2017] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Abstract
At total mean incidence of 0.84–1.1/100,000 the occurrence of Guillain‐Barré syndrome (GBS) is reported to be low in Finland compared to other Caucasian populations. However, a recent study from Southwestern Finland reported an incidence of 1.82/100,000 which is comparable to other Caucasian populations. We analyzed discharge data covering the years 2004 through 2014 on all neurological admissions in all Finnish university and central hospitals with a primary diagnosis of GBS. A total of 989 admissions due to GBS (917 individuals) were identified. The standardized (European population) annual incidence rate was 1.70/100,000 person‐years (95% confidence interval 1.60–1.81). GBS incidence had an increasing trend with age. The likelihood of GBS was higher among girls and adolescent women than boys and men of same age (male:female incidence rate ratio [IRR] 0.56), while in the older age groups (>19 years) the occurrence of GBS was higher among males than females (male:female IRR 1.59). The incidence of GBS remained stable during the study period. There was no seasonal variation in GBS admission frequencies (p = 0.28). No significant effect of the 2009–2010 H1N1 influenza or vaccination against it for GBS occurrence was observed. We suggest that GBS is as common, and has similar age‐distribution in Finland as in other European countries. Sex‐associated susceptibility for GBS appears to be different in children‐adolescents and adults.
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Affiliation(s)
- Jussi O T Sipilä
- Siun sote, North Karelia Central Hospital, Department of Neurology, Joensuu, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - Merja Soilu-Hänninen
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Neurology, University of Turku, Turku, Finland
| | - Jori O Ruuskanen
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Neurology, University of Turku, Turku, Finland.,Medbase Ltd, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, University of Turku and Turku Clinical Research Centre, Turku University Hospital, Turku, Finland
| | - Ville Kytö
- Heart Center, Turku University Hospital, Turku, Finland.,Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Kim J, Choi HY, Lee YM, Kim JS. Posttraumatic Guillain-Barré Syndrome Immediately Following a Traffic Accident. KOREAN JOURNAL OF SPINE 2017; 14:121-123. [PMID: 29017313 PMCID: PMC5642090 DOI: 10.14245/kjs.2017.14.3.121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/03/2017] [Accepted: 09/05/2017] [Indexed: 12/28/2022]
Abstract
Guillain-Barré syndrome (GBS) is an inflammatory demyelinating polyneuropathy characterized by areflexic paralysis. Most cases of GBS are preceded by an infection, however, posttraumatic GBS has also recently been reported. We report a case of posttraumatic GBS immediately following a traffic accident. We think this case is of clinical significance for practitioners because of the rare cause of a sudden flaccid paralysis following trauma.
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Affiliation(s)
- Jungook Kim
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ho Yong Choi
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young Min Lee
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Joon Soo Kim
- Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Abstract
Guillain-Barré syndrome is a rare autoimmune condition characterized by ascending motor weakness of the extremities that can ascend to the diaphragm, causing substantial morbidity and mortality. This case report describes a 57-year-old man who exhibited characteristics of Guillain-Barré syndrome 9 days after undergoing lumbar fusion at L3-S1. The diagnosis was based on the patient's ascending motor weakness and areflexia and was confirmed with electromyography. The patient progressed to respiratory failure, requiring mechanical ventilation. He regained motor function and ambulation within 6 months. Although the syndrome typically manifests initially as ascending paralysis, this patient's initial symptom was new-onset atrial fibrillation, a sign of autonomic dysfunction. Because it can cause paralysis and respiratory failure, Guillain-Barré syndrome should be included in the differential diagnosis whenever motor weakness is observed after lumbar surgery. The timing of symptoms, imaging results, and the development of atypical symptoms can help distinguish this rare possibility from other postoperative spinal complications.
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Li X, Xiao J, Ding Y, Xu J, Li C, He Y, Zhai H, Xie B, Hao J. Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome. BMC Neurol 2017; 17:142. [PMID: 28750621 PMCID: PMC5531106 DOI: 10.1186/s12883-017-0919-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 07/12/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Post-traumatic Guillain-Barré syndrome (GBS) is a rarely described potentially life-threatening cause of weakness. We sought to elucidate the clinical features and electrophysiological patterns of post-traumatic GBS as an aid to diagnosis. METHODS We retrospectively studied six patients diagnosed with post-traumatic GBS between 2014 and 2016 at Tianjin Medical University General Hospital, China. Clinical features, serum analysis, lumbar puncture results, electrophysiological examinations, and prognosis were assessed. RESULTS All six patients had different degrees of muscular atrophy at nadir and in two, respiratory muscles were involved. Five also had damaged cranial nerves and four of these had serum antibodies against gangliosides. The most common electrophysiological findings were relatively normal distal latency, prominent reduction of compound muscle action potential amplitude, and absence of F-waves, which are consistent with an axonal form of GBS. CONCLUSIONS It is often overlooked that GBS can be triggered by non-infectious factors such as trauma and its short-term prognosis is poor. Therefore, it is important to analyze the clinical and electrophysiological features of GBS after trauma. Here we have shown that electrophysiological evaluations are helpful for diagnosing post-traumatic GBS. Early diagnosis may support appropriate treatment to help prevent morbidity and improve prognosis.
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Affiliation(s)
- Xiaowen Li
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jinting Xiao
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Yanan Ding
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jing Xu
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Chuanxia Li
- Department of Neurology, Tianjin Haihe Hospital, Tianjin, 300060, China
| | - Yating He
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Hui Zhai
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Bingdi Xie
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Junwei Hao
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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Abstract
Guillain-Barré syndrome (GBS) is a term that is used to describe a group of immune-mediated peripheral neuropathies, with the most common feature being rapid polyradiculoneuropathy. The exact etiology of this syndrome is unknown. In the field of orthopedics, GBS has been reported to occur after total hip arthroplasty, orthopedic trauma, and spine surgery. We report a unique case of GBS after elective revision lumbar spine surgery. A 62-year-old female presented with persistent low back pain and radiculopathy and elected to have revision lumbar spine surgery. Approximately 24 to 36 hours after hospital discharge, she returned to the hospital with weakness in her legs. After an electromyography (EMG), the patient was diagnosed with GBS and placed on intravenous immunoglobulin (IVIG). She developed respiratory failure, which required intubation and eventually converted to a tracheostomy and was finally decannulated. Over the course of 12 months, she improved to her pre-surgical baseline, gaining 5/5 strength in her upper and lower extremities and was able to ambulate independently without any aids. This was a case of GBS that occurred in a patient approximately two weeks after revision lumbar surgery. GBS is a poorly understood and rare complication of lumbar spine surgery that needs to be recognized quickly to be effectively treated.
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Affiliation(s)
- Aymen Rashid
- Department of Orthopedic Surgery, SUNY Upstate Medical University
| | - Swamy Kurra
- Department of Orthopedic Surgery, SUNY Upstate Medical University
| | - William Lavelle
- Department of Orthopedic Surgery, SUNY Upstate Medical University
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Yang B, Lian Y, Liu Y, Wu BY, Duan RS. A retrospective analysis of possible triggers of Guillain–Barre syndrome. J Neuroimmunol 2016; 293:17-21. [DOI: 10.1016/j.jneuroim.2016.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 02/07/2023]
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Samieirad S, Khajehahmadi S, Tohidi E, Barzegar M. Unusual Presentation of Guillain-Barré Syndrome After Mandibular Fracture Treatment: A Review of the Literature and a New Case. J Oral Maxillofac Surg 2015; 74:129.e1-6. [PMID: 26454033 DOI: 10.1016/j.joms.2015.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 12/30/2022]
Abstract
Guillain-Barré syndrome (GBS) is a multifactorial and lethal inflammatory demyelinating neuronal disorder with concurrent polyradiculopathy and polyneuropathy presentations. This rare syndrome affects the peripheral nerve myelin sheath and is characterized by ascending muscle weakness and paralysis. There have been rare reports of GBS after head or brachial plexus trauma, general anesthesia, neurosurgery, orthopedic surgery, cesarean section, laparoscopy, and general surgery, and the occurrence of GBS after oral and maxillofacial surgery is not common. A review of the related literature and a new case of GBS after maxillofacial surgery are presented.
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Affiliation(s)
- Sahand Samieirad
- Assistant Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Diseases Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Assistant Professor of Oral and Maxillofacial Pathology, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Tohidi
- Assistant Professor of Oral and Maxillofacial Radiology, Oral and Maxillofacial Diseases Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Barzegar
- Postgraduate Student of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.
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Wu X, Wang J, Liu K, Zhu J, Zhang HL. Are Th17 cells and their cytokines a therapeutic target in Guillain–Barré syndrome? Expert Opin Ther Targets 2015; 20:209-22. [DOI: 10.1517/14728222.2016.1086751] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Boghani Z, Livingston AD, Simpson EP, Holman PJ, Grossman RG. Acute Onset of Guillain-Barré Syndrome After Elective Spinal Surgery. World Neurosurg 2015; 84:376-9. [PMID: 25836269 DOI: 10.1016/j.wneu.2015.03.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Guillain-Barré syndrome (GBS) is an acute peripheral neuropathy caused by an autoimmune response against myelin of peripheral nerves. GBS has been reported after surgery, in general, and after spinal surgery, in particular. In most cases, GBS developed 1-3 weeks after surgery. METHODS Report of 2 cases of GBS after elective spine surgery that developed in the immediate postoperative period. RESULTS Within 1 and 3 hours after surgery, respectively, both patients developed ascending loss of motor and sensory function. They were taken back urgently to the operating room for wound exploration to ensure that an epidural hematoma had not developed. Cerebrospinal fluid studies and electromyography/nerve conduction velocity were then rapidly obtained and were compatible with acute inflammatory demyelinating polyradiculoneuropathy. Therapy was initiated with administration of intravenous immunoglobulin and plasmapheresis. Both patients made substantial motor recovery during the course of 1-2 years but have residual sensory abnormalities. CONCLUSIONS GBS developing acutely after spinal surgery is a rare occurrence but should be considered in the differential diagnosis of neurological deterioration after surgery. Rapid diagnosis and treatment are essential for recovery of neurological function.
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Affiliation(s)
- Zain Boghani
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, Texas, USA
| | - Andrew D Livingston
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, Texas, USA
| | - Ericka P Simpson
- Department of Neurology, Houston Methodist Hospital Neurological Institute, Houston, Texas, USA
| | - Paul J Holman
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, Texas, USA
| | - Robert G Grossman
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, Texas, USA.
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Guillain-Barre Syndrome After Robotically Assisted Laparoscopic Prostatectomy: First Case Report. Urol Case Rep 2015; 3:44-6. [PMID: 26793497 PMCID: PMC4714275 DOI: 10.1016/j.eucr.2015.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/07/2015] [Accepted: 01/12/2015] [Indexed: 11/27/2022] Open
Abstract
Guillain-Barre Syndrome is a well described acute demyelinating polyradiculoneuropathy with a likely autoimmune basis characterized by progressive ascending muscle paralysis. Classically, GBS is attributed to antecedent upper respiratory and gastrointestinal infections. We present the first case of GBS after Robotically Assisted Laparoscopic Prostatectomy using the daVinci® Surgical System.
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Key Words
- Ascending muscle paralysis
- CSF, Cerebrospinal Fluid
- ED, Emergency Department
- GBS, Guillain-Barre Syndrome
- Guillain-Barre syndrome
- HSV, Herpes Simplex Virus
- ICU, Intensive Care Unit
- IVIG, Intravenous Immunoglobulin
- PCR, Polymerase Chain Reaction
- POD, Post operative day
- Prostate cancer
- RBC, Red Blood Cell
- Robotically assisted laparoscopic prostatectomy
- TSH, Thyroid Stimulating Hormone
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Gullain-Barré Syndrome After Posterior Fossa Tumor Surgery. World Neurosurg 2014; 82:e838-40. [DOI: 10.1016/j.wneu.2014.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/19/2014] [Accepted: 09/03/2014] [Indexed: 11/17/2022]
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Carr KR, Shah M, Garvin R, Shakir A, Jackson C. Post-Traumatic brain injury (TBI) presenting with Guillain-Barré syndrome and elevated anti-ganglioside antibodies: a case report and review of the literature. Int J Neurosci 2014; 125:486-92. [PMID: 25158009 DOI: 10.3109/00207454.2014.957760] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Guillain-Barré Syndrome (GBS) is a demyelinating polyneuropathy resulting in sensory, motor and autonomic symptoms. The severity of the disease can range from mild to severe but it is classically described as an ascending demyelinating process. Initially thought to be the sequelae of a bacterial or viral infection, the clinical symptoms of post-infective GBS can present up to 4 weeks after sentinel injury. A rarely defined post-surgical GBS has been since described after major cranial, cardiothoracic and gastro-intestinal surgery. Post traumatic GBS is an even more unusual presentation with very few cases reported in contemporary academic literature. We present a case of GBS presenting two weeks after non-operative traumatic brain injury (TBI) and a review of the literature.
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Affiliation(s)
- Kevin R Carr
- 1Department of Neurosurgery, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA
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Velázquez Benito A, Bellosta Diago E, Santos Lasaosa S, Pascual Millán LF. [Acute sensory-motor axonal neuropathy (Guillain-Barre syndrome) following vertebroplasty]. Med Clin (Barc) 2014; 143:282-3. [PMID: 24447691 DOI: 10.1016/j.medcli.2013.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Alba Velázquez Benito
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - Elena Bellosta Diago
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Sonia Santos Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Sipilä JOT, Soilu-Hänninen M. The incidence and triggers of adult-onset Guillain-Barré syndrome in southwestern Finland 2004-2013. Eur J Neurol 2014; 22:292-8. [PMID: 25196425 DOI: 10.1111/ene.12565] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 07/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE A Swiss study recently reported surgery as a potential risk factor for developing Guillain-Barré syndrome (GBS). It was sought to establish this in the Finnish adult population. METHODS Persons over 16 years of age who received a diagnosis of GBS in 2004-2013 were identified from the patient register of Turku University Hospital and their patient records were analyzed to identify possible triggers. RESULTS A cohort of 69 adult patients with GBS (63.8% men) was identified giving an annual incidence of 1.82/100,000. Of these, four (5.8%) had experienced a surgical procedure during the preceding 6 weeks with a relative risk of 6.28 (95% confidence interval 4.15-9.47, P < 0.001) compared with the general study population or a risk of 1.25/100,000 operations. No difference between genders was found. Only two (2.9%) patients had received a vaccination [one against seasonal influenza (P = 0.888) and one against pandemic influenza (Pandemrix(®), GlaxoSmithKline Biologicals, Rixensart, Belgium, relative risk 2.85, 95% confidence interval 1.27-6.38, P = 0.011)] during the preceding 6 weeks. The most common GBS triggers identified were respiratory tract infections in 30 cases (43.5%) and gastroenteritis in 16 cases (23.2%) whilst two patients (2.9%) had had both. CONCLUSIONS The overall incidence of GBS in the adult population of southwestern Finland was similar to previous studies worldwide and the most common triggers were respiratory tract infections and gastroenteritis. Surgery was a rare risk factor and of vaccinations only the one against pandemic influenza raised the risk of GBS.
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Affiliation(s)
- J O T Sipilä
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland
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66
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Guillain-Barre Syndrome After Lung Lobectomy: Is There Any Relationship? Ann Thorac Surg 2014; 97:e133-4. [DOI: 10.1016/j.athoracsur.2013.12.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 11/20/2013] [Accepted: 12/18/2013] [Indexed: 11/24/2022]
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Wakerley BR, Yuki N. Infectious and noninfectious triggers in Guillain-Barré syndrome. Expert Rev Clin Immunol 2014; 9:627-39. [PMID: 23899233 DOI: 10.1586/1744666x.2013.811119] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Guillain-Barré syndrome (GBS) is the commonest cause of acquired flaccid paralysis in the world and regarded by many as the prototype for postinfectious autoimmunity. Here the authors consider both infectious and noninfectious triggers of GBS and determine where possible what immunological mechanisms may account for this association. In approximately two-thirds of cases, an infectious trigger is reported in the weeks that lead up to disease onset, indicating that the host's response to infection must play an important role in disease pathogenesis. The most frequently identified bacteria, Campylobacter jejuni, through a process known as molecular mimicry, has been shown to induce cross-reactive anti-ganglioside antibodies, which can lead to the development of axonal-type GBS in some patients. Whether this paradigm can be extended to other infectious organisms or vaccines remains an important area of research and has public health implications. GBS has also been reported rarely in patients with underlying systemic diseases and immunocompromised states and although the exact mechanism is yet to be established, increased susceptibility to known infectious triggers should be considered most likely.
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Affiliation(s)
- Benjamin R Wakerley
- Department of Medicine, National University Hospital, 1E Kent Ridge Road, Singapore.
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69
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Wakerley BR, Yuki N. Surgery itself does not trigger Guillain-Barré syndrome. Eur J Neurol 2013; 20:e40. [PMID: 23406451 DOI: 10.1111/ene.12065] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 09/12/2012] [Indexed: 12/13/2022]
Affiliation(s)
- B R Wakerley
- Department of Medicine, National University Hospital, Singapore
| | - N Yuki
- Department of Medicine, National University Hospital, Singapore
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Gensicke H, Fischer D. Response to Wakerley et al. letter: Surgery itself does not trigger Guillain-Barré syndrome. Eur J Neurol 2013; 20:e41. [PMID: 23406452 DOI: 10.1111/ene.12064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 11/07/2012] [Indexed: 11/30/2022]
Affiliation(s)
- H Gensicke
- Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - D Fischer
- Department of Neurology, University Hospital Basel, Basel, Switzerland.,Department of Neuropaediatrics, University Children's Hospital Basel, Basel, Switzerland
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Jakes AD, Jani P, Bhandari S. Case Report: Guillain-Barre� Syndrome following Renal Transplantation - A Diagnostic Dilemma. ACTA ACUST UNITED AC 2013; 124:239-42. [DOI: 10.1159/000358087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Cingoz F, Tavlasoglu M, Kurkluoglu M, Sahin MA. Guillain-Barre syndrome after coronary artery bypass surgery. Interact Cardiovasc Thorac Surg 2012; 15:918-9. [PMID: 22899666 DOI: 10.1093/icvts/ivs367] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A case of the Guillain-Barré syndrome occurring after otherwise uneventful cardiac surgery using cardiopulmonary bypass is presented. Though the Guillain-Barré syndrome has been reported after surgical procedures, there are very few case reports after cardiopulmonary bypass surgery in the literature. The exact pathophysiological cause of the syndrome is still unknown. However, the most widely accepted hypothesis is that the syndrome is the result of an immune-mediated process. Cardiac surgery may be a trigger for immune-mediated response.
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Affiliation(s)
- Faruk Cingoz
- Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Ankara, Turkey
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