1
|
Jasqui-Bucay A, Moctezuma-Velazquez C, Pacheco-Aispuro G, Vilatobá-Chapa M, Aguirre-Valadez J. Occurrence of Guillain-Barré Syndrome in the Early Post-operative Period After an Urgent Liver Transplant. Cureus 2024; 16:e63304. [PMID: 38938905 PMCID: PMC11210954 DOI: 10.7759/cureus.63304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 06/29/2024] Open
Abstract
Solid organ transplant recipients are prone to developing a wide range of complications associated with the procedure itself, as well as with immunosuppressants. Guillain-Barré syndrome, which is part of the spectrum of inflammatory neuropathies, is not expected to occur early after organ transplant when immunosuppression is at its highest point. We describe the clinical case of a patient who underwent an urgent liver transplant due to acute liver failure secondary to drug-induced liver injury and developed Guillain-Barré syndrome early after the transplant.
Collapse
Affiliation(s)
| | - Carlos Moctezuma-Velazquez
- Medicine, Division of Gastroenterology - Liver Unit, Department of Medicine, University of Alberta, Edmonton, CAN
| | | | - Mario Vilatobá-Chapa
- Transplant Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MEX
| | | |
Collapse
|
2
|
Piña-Rosales E, Gonzalez-Salido J, Barron-Cervantes NM, Colado-Martinez J, Garcia-Santos RA, Guevara-Arnal L. Guillain-Barré Syndrome in an Immunocompromised Patient: A Case Report. Cureus 2024; 16:e54380. [PMID: 38505462 PMCID: PMC10948623 DOI: 10.7759/cureus.54380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/21/2024] Open
Abstract
Guillain-Barré syndrome (GBS) in post-transplant patients is a rare clinical presentation. Although in the literature this neurological condition has been mainly associated with viral infections secondary to immunosuppression, GBS should not only be suspected in patients with an acute condition. It is essential to always rule out a viral or bacterial cause, looking for the most common sources, i.e., urinary, respiratory, and gastrointestinal. The diagnosis of GBS is clinically based, and its management is based on the use of intravenous immunoglobulin (IVIG) or plasma exchange. Its timely diagnosis allows treatment to be started early, thus improving the prognosis of these patients and reducing the time of hospitalization and complications associated with it. This report shows how an interdisciplinary approach is vital in such cases, as both the precipitant and the disease must be managed to decrease the morbidity and mortality associated with this condition. It is crucial to evaluate the benefits and risks of withdrawing immunosuppressive treatment in post-transplant patients, and being able to recognize when restarting them is indicated.
Collapse
Affiliation(s)
- Enrique Piña-Rosales
- Internal Medicine, Fundación Clínica Médica Sur (South Medical Clinical Foundation), Mexico City, MEX
| | - Jimena Gonzalez-Salido
- Medicine, School of Medicine, Universidad La Salle (La Salle University), Mexico City, MEX
| | | | - Jimena Colado-Martinez
- Medicine, School of Medicine, Universidad La Salle (La Salle University), Mexico City, MEX
| | - Raúl A Garcia-Santos
- Neurology, Fundación Clínica Médica Sur (South Medical Clinical Foundation), Mexico City, MEX
| | - Luis Guevara-Arnal
- Nephrology, Fundación Clínica Médica Sur (South Medical Clinical Foundation), Mexico City, MEX
| |
Collapse
|
3
|
Tavakoli F, Dalil D, Yaghoubi F, Hosseini SM. Guillain-Barre syndrome after antithymocyte globulin administration in a kidney transplant recipient: A case report and literature review. Clin Case Rep 2023; 11:e8184. [PMID: 38028101 PMCID: PMC10651983 DOI: 10.1002/ccr3.8184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/07/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023] Open
Abstract
This report describes a rare case of developing Guillain-Barre syndrome (GBS) following receiving rabbit antithymocyte globulin (ATG) after kidney transplantation to prevent acute allograft rejection in a 34-year-old man. The patient presented severe pain in the right temporomandibular joint, fever, chills, myalgia, polyarthralgia, and bone pain. Twelve hours later, he developed quadriplegia, paresthesia, and a limited range of active motions in all extremities. No antecedent viral or bacterial infection was identified. The EMG/NCV evaluation displayed acute inflammatory sensory-motor polyneuropathy. After the administration of GBS treatment, the neurologic symptoms started to improve. Over a few days, the reflexes came back completely, and the patient was able to walk. To our knowledge, this is the second case report of ATG-related GBS after kidney transplantation.
Collapse
Affiliation(s)
- Farnaz Tavakoli
- Nephrology Research Center, Shariati HospitalTehran University of Medical SciencesTehranIran
| | - Davood Dalil
- Nephrology Research Center, Shariati HospitalTehran University of Medical SciencesTehranIran
- Student Research Committee, Faculty of MedicineShahed UniversityTehranIran
| | - Fatemeh Yaghoubi
- Nephrology Research Center, Shariati HospitalTehran University of Medical SciencesTehranIran
| | | |
Collapse
|
4
|
De León AM, Garcia-Santibanez R, Harrison TB. Article Topic: Neuropathies Due to Infections and Antimicrobial Treatments. Curr Treat Options Neurol 2023; 25:1-17. [PMID: 37360749 PMCID: PMC10256960 DOI: 10.1007/s11940-023-00756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/28/2023]
Abstract
Purpose of eview The aim of this review is to discuss the presentation, diagnosis, and management of polyneuropathy (PN) in selected infections. Overall, most infection related PNs are an indirect consequence of immune activation rather than a direct result of peripheral nerve infection, Schwann cell infection, or toxin production, though note this review will describe infections that cause PN through all these mechanisms. Rather than dividing them by each infectious agent separately, we have grouped the infectious neuropathies according to their presenting phenotype, to serve as a guide to clinicians. Finally, toxic neuropathies related to antimicrobials are briefly summarized. Recent findings While PN from many infections is decreasing, increasing evidence links infections to variants of GBS. Incidence of neuropathies secondary to use of HIV therapy has decreased over the last few years. Summary In this manuscript, a general overview of the more common infectious causes of PN will be discussed, dividing them across clinical phenotypes: large- and small-fiber polyneuropathy, Guillain-Barré syndrome (GBS), mononeuritis multiplex, and autonomic neuropathy. Rare but important infectious causes are also discussed.
Collapse
Affiliation(s)
- Andrés M. De León
- Neuromuscular Division Department of Neurology, Emory University, Executive Park 12 NE, GA 30329 Atlanta, USA
| | - Rocio Garcia-Santibanez
- Neuromuscular Division Department of Neurology, Emory University, Executive Park 12 NE, GA 30329 Atlanta, USA
| | - Taylor B. Harrison
- Division of Neuromuscular Medicine, Department of Neurology, Emory University School of Medicine, 83 Jessie Junior Drive Box 039, Atlanta, GA 30303 USA
| |
Collapse
|
5
|
Malekpour M, Khanmohammadi S, Meybodi MJE, Shekouh D, Rahmanian MR, Kardeh S, Azarpira N. COVID-19 as a trigger of Guillain-Barré syndrome: A review of the molecular mechanism. Immun Inflamm Dis 2023; 11:e875. [PMID: 37249286 DOI: 10.1002/iid3.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic with serious complications. After coronavirus disease 2019 (COVID-19), several post-acute COVID-19 syndromes (PACSs) and long-COVID sequels were reported. PACSs involve many organs, including the nervous, gustatory, and immune systems. One of the PACSs after SARS-CoV-2 infection and vaccination is Guillain-Barré syndrome (GBS). The incidence rate of GBS after SARS-CoV-2 infection or vaccination is low. However, the high prevalence of COVID-19 and severe complications of GBS, for example, autonomic dysfunction and respiratory failure, highlight the importance of post-COVID-19 GBS. It is while patients with simultaneous COVID-19 and GBS seem to have higher admission rates to the intensive care unit, and demyelination is more aggressive in post-COVID-19 GBS patients. SARS-CoV-2 can trigger GBS via several pathways like direct neurotropism and neurovirulence, microvascular dysfunction and oxidative stress, immune system disruption, molecular mimicry, and autoantibody production. Although there are few molecular studies on the molecular and cellular mechanisms of GBS occurrence after SARS-CoV-2 infection and vaccination, we aimed to discuss the possible pathomechanism of post-COVID-19 GBS by gathering the most recent molecular evidence.
Collapse
Affiliation(s)
- Mahdi Malekpour
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shaghayegh Khanmohammadi
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Entezari Meybodi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dorsa Shekouh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Rahmanian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Kardeh
- Central Clinical School, Monash University, Melbourne, Australia
| | - Negar Azarpira
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
6
|
Finsterer J. Triggers of Guillain-Barré Syndrome: Campylobacter jejuni Predominates. Int J Mol Sci 2022; 23:ijms232214222. [PMID: 36430700 PMCID: PMC9696744 DOI: 10.3390/ijms232214222] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
Guillain-Barré syndrome (GBS) is a rare immune-mediated acute polyradiculo-neuropathy that typically develops after a previous gastrointestinal or respiratory infection. This narrative overview aims to summarise and discuss current knowledge and previous evidence regarding triggers and pathophysiology of GBS. A systematic search of the literature was carried out using suitable search terms. The most common subtypes of GBS are acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). The most common triggers of GBS, in three quarters of cases, are previous infections. The most common infectious agents that cause GBS include Campylobacter jejuni (C. jejuni), Mycoplasma pneumoniae, and cytomegalovirus. C. jejuni is responsible for about a third of GBS cases. GBS due to C. jejuni is usually more severe than that due to other causes. Clinical presentation of GBS is highly dependent on the structure of pathogenic lipo-oligosaccharides (LOS) that trigger the innate immune system via Toll-like-receptor (TLR)-4 signalling. AIDP is due to demyelination, whereas in AMAN, structures of the axolemma are affected in the nodal or inter-nodal space. In conclusion, GBS is a neuro-immunological disorder caused by autoantibodies against components of the myelin sheath or axolemma. Molecular mimicry between surface structures of pathogens and components of myelin or the axon is one scenario that may explain the pathophysiology of GBS.
Collapse
|
7
|
Faravelli I, Velardo D, Podestà MA, Ponticelli C. Immunosuppression-related neurological disorders in kidney transplantation. J Nephrol 2021; 34:539-555. [PMID: 33481222 PMCID: PMC8036223 DOI: 10.1007/s40620-020-00956-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/27/2020] [Indexed: 01/06/2023]
Abstract
A large number of neurological disorders can affect renal transplant recipients, potentially leading to disabling or life-threatening complications. Prevention, early diagnosis and appropriate management of these conditions are critical to avoid irreversible lesions. A pivotal role in the pathogenesis of common post-transplant neurological disorders is played by immunosuppressive therapy. The most frequently administered regimen consists of triple immunosuppression, which comprises a calcineurin inhibitor (CNI), a purine synthesis inhibitor and glucocorticoids. Some of these immunosuppressive drugs may lead to neurological signs and symptoms through direct neurotoxic effects, and all of them may be responsible for the development of tumors or opportunistic infections. In this review, after a brief summary of neurotoxic pathogenetic mechanisms encompassing recent advances in the field, we focus on the clinical presentation of more common and severe immunosuppression-related neurological complications, classifying them by characteristics of urgency and anatomic site. Our goal is to provide a general framework that addresses such clinical issues with a multidisciplinary approach, as these conditions require.
Collapse
Affiliation(s)
- Irene Faravelli
- Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, Università degli Studi di Milano, Milan, Italy.
| | - Daniele Velardo
- Neurology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Manuel Alfredo Podestà
- Renal Division, ASST Santi Paolo e Carlo, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | | |
Collapse
|
8
|
Schiaffino F, Kosek MN. Intestinal and Extra-Intestinal Manifestations of Campylobacter in the Immunocompromised Host. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020. [DOI: 10.1007/s40506-020-00243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Zakrocka I, Baranowicz-Gąszczyk I, Korolczuk A, Załuska W. Guillain-Barre syndrome: a typical paraneoplastic syndrome in a kidney transplant recipient with allograft renal cell carcinoma: a case report and review of the literature. BMC Nephrol 2020; 21:434. [PMID: 33054714 PMCID: PMC7560006 DOI: 10.1186/s12882-020-02095-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Guillain-Barré syndrome (GBS) is an autoimmune polyneuropathy affecting the peripheral nervous system. This neurological disorder has been previously reported in bone marrow transplant recipients but is uncommon after kidney transplantation. Viral infections and calcineurin inhibitors are the main triggers of GBS in renal transplant recipients. CASE PRESENTATION In this report, we present a case of a 47-year-old male patient 12 years after his second kidney transplantation who developed GBS due to papillary renal cell carcinoma. Infectious and drug-related origins of GBS were excluded. Despite intensive treatment, graftectomy was performed, after which neurological symptoms resolved. CONCLUSIONS In kidney transplant recipients, paraneoplastic aetiology should be considered in the differential diagnosis of GBS.
Collapse
Affiliation(s)
- Izabela Zakrocka
- Department of Nephrology, Medical University, Jaczewskiego street 8, 20-090, Lublin, Poland.
| | | | | | - Wojciech Załuska
- Department of Nephrology, Medical University, Jaczewskiego street 8, 20-090, Lublin, Poland
| |
Collapse
|
10
|
Orcurto A, Hottinger A, Wolf B, Navarro Rodrigo B, Ochoa de Olza M, Auger A, Kuntzer T, Comte D, Zimmer V, Gannon P, Kandalaft L, Michielin O, Zimmermann S, Harari A, Trueb L, Coukos G. Guillain-Barré syndrome after adoptive cell therapy with tumor-infiltrating lymphocytes. J Immunother Cancer 2020; 8:jitc-2020-001155. [PMID: 32847987 PMCID: PMC7451492 DOI: 10.1136/jitc-2020-001155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) is a promising experimental immunotherapy that has shown high objective responses in patients with melanoma. Current protocols use a lymphodepletive chemotherapy before infusion of ex vivo expanded TILs, followed by high-dose interleukin-2 (IL-2). Treatment-related toxicities are mainly attributable to the chemotherapy regimen and to the high-dose IL-2 and are generally reversible. Neurological side effects have rarely been described. Nevertheless, due to improvements in cell production techniques and due to combinations with other immunomodulating molecules, side effects not previously described may be encountered. CASE PRESENTATION We report the case of a 53-year-old heavily pretreated patient with melanoma who developed Guillain-Barré syndrome (GBS) 19 days after ACT using autologous TILs, given in the context of a phase I trial. He presented with dorsal back pain, unsteady gait and numbness in hands and feet. Lumbar puncture showed albuminocytological dissociation, and nerve conduction studies revealed prolonged distal motor latencies in median, ulnar, tibial and peroneal nerves, compatible with a GBS. The patient was treated with intravenous immunoglobulins and intensive neurological rehabilitation, with progressive and full recovery at 21 months post-TIL-ACT. Concomitant to the onset of GBS, a cytomegalovirus reactivation on immunosuppression was detected and considered as the most plausible cause of this neurological side effect. CONCLUSION We describe for the first time a case of GBS occurring shortly after TIL-ACT for melanoma, even though we could not identify with certainty the triggering agent. The report of such rare cases is of extreme importance to build on the knowledge of immune cellular therapies and their specific spectrum of toxicities.
Collapse
Affiliation(s)
- Angela Orcurto
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Andreas Hottinger
- Oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland.,Service of Neurology, Department of Clinical Neurosciences, CHUV, Lausanne, Vaud, Switzerland
| | - Benita Wolf
- Oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Blanca Navarro Rodrigo
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland.,Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland
| | - Maria Ochoa de Olza
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland.,Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland
| | - Aymeric Auger
- Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland.,Center of Experimental Therapeutics, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Thierry Kuntzer
- Service of Neurology, Department of Clinical Neurosciences, CHUV, Lausanne, Vaud, Switzerland
| | - Denis Comte
- Service of Immunology and Allergy, Department of Medicine, CHUV, Lausanne, Vaud, Switzerland
| | - Virginie Zimmer
- Center of Experimental Therapeutics, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Philippe Gannon
- Center of Experimental Therapeutics, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Lana Kandalaft
- Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland.,Center of Experimental Therapeutics, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Olivier Michielin
- Oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Stefan Zimmermann
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Alexandre Harari
- Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland.,Center of Experimental Therapeutics, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - Lionel Trueb
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland
| | - George Coukos
- Immuno-oncology Service, Department of Oncology, CHUV, Lausanne, Vaud, Switzerland.,Ludwig Institute for Cancer Research, Lausanne Branch, University of Lausanne, Epalinges, Vaud, Switzerland
| |
Collapse
|
11
|
Badierah RA, Uversky VN, Redwan EM. Dancing with Trojan horses: an interplay between the extracellular vesicles and viruses. J Biomol Struct Dyn 2020; 39:3034-3060. [DOI: 10.1080/07391102.2020.1756409] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Raied A. Badierah
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Molecular Diagnostic Laboratory, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Vladimir N. Uversky
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Laboratory of New Methods in Biology, Institute for Biological Instrumentation, Russian Academy of Sciences, Federal Research Center ‘Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences’, Pushchino, Moscow Region, Russia
| | - Elrashdy M. Redwan
- Biological Science Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
12
|
van der Zwan M, Hesselink DA, Brusse E, van Doorn PA, van den Hoogen MWF, de Weerd AE, Jacobs BC. Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy after alemtuzumab therapy in kidney transplant recipients. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/4/e721. [PMID: 32299841 PMCID: PMC7188471 DOI: 10.1212/nxi.0000000000000721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/13/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Marieke van der Zwan
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - Dennis A Hesselink
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Esther Brusse
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Pieter A van Doorn
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Martijn W F van den Hoogen
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Annelies E de Weerd
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Bart C Jacobs
- From the Department of Internal Medicine (M.Z., D.A.H., M.W.F.H., A.E.W.), Division of Nephrology and Transplantation; Rotterdam Transplant Group (M.Z., D.A.H., M.W.F.H., A.E.W.); Department of Neurology (E.B., P.A.D., B.C.J.); and Immunology (E.B., P.A.D., B.C.J.), Erasmus MC, University Medical Center Rotterdam, the Netherlands
| |
Collapse
|
13
|
Guillain-Barré syndrome in a heart transplantation recipient. J Am Assoc Nurse Pract 2020; 33:639-645. [PMID: 32282569 DOI: 10.1097/jxx.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 01/16/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT A rare case of a heart transplantation recipient with Guillain-Barré syndrome occurred, which was associated with peripheral nervous system damage. Based on a review of epidemiological research, the symptom development process, and diagnostic tools, the authors highlight the extreme rarity of this postinfectious immune disease. After diagnosis, plasma exchange and immunoregulatory therapy should be performed because they result in rapid recovery. If there is delayed diagnosis and treatment, there is a high risk of disability or death. When patients experience acute limb paralysis as the main symptom, nurse practitioners (NPs) should focus on the patient's history, particularly with regard to infectious agents. Closely monitoring the patient to detect respiratory failure and the need for early respiratory intervention can help the patient to avoid the severe complication of permanent brain injury. For NPs, performance of early differential diagnosis is important, especially among patients who have immunosuppressive dependence after transplantation.
Collapse
|
14
|
Etta P, Subhramanyam S, Nayak K. Guillain-Barre syndrome in a pregnant-live-related ABO-incompatible renal allograft recipient. Indian J Nephrol 2020; 30:211-212. [PMID: 33013076 PMCID: PMC7470194 DOI: 10.4103/ijn.ijn_206_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/05/2019] [Accepted: 10/30/2019] [Indexed: 11/05/2022] Open
|
15
|
Etta P, Subhramanyam S, Mathur V, Nayak K. Guillain–Barre syndrome in an ABO-incompatible renal allograft recipient during pregnancy treated with plasma exchange. INDIAN JOURNAL OF TRANSPLANTATION 2019. [DOI: 10.4103/ijot.ijot_20_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|