Context: Guillain-Barré syndrome is a polyradiculoneuropathy of heterogeneous manifestations, necessarily presenting progressive appendicular weakness of variable intensity associated with reduction or abolition of deep reflexes. One of its variants is known as Miller Fisher Syndrome (MFS), characterized by ophthalmoparesis, ataxy and areflexia. It usually has, by etiology, immunomediated reactions induced by acute infections, including HIV. Objectives: This report aims to describe a case of MFS with concomitants HIV infection, attended in a tertiary hospital in northern Paraná and compared it with the literature. [1,7] Case report: A 27-year-old white male patient who presented binocular diplopia, dysarthria, dysphagia, generalized hypotonia, myasfasciculations, sensory ataxia and arreflexia, with a score on the Medical Research Council (MRC) muscle strength scale of 54 points. Treatment with empirical intravenous human immunoglobulina ( IVIG ) was performed pending the result of serologies for etiological screening. He was discharged after eleven days of hospitalization with partial symptomatic improvement and results indicative of acute HIV infection. We compared this case with those described in the published literature Discussion: We compared this case with those described in the published literature and given the low incidence found in the literature of patients with the stage of HIV viremia and the opening of the picture of SMF, the concrete pathophysiology itself is still unknown. The mechanism, however, in which the literature proposes in two theories: (1) an autoimmune action against myelin due to abnormal immunoregulation by HIV; (2) direct action of neurotropic strains of HIV-1. [2.3] Our literature review shows that since 1995, cases of associated guillain barré syndrome have already been reported in the course of HIV viremia. Treatment with immunoglobulin at a dose of 400mg / kg / day for 5 days was done and the symptoms improved. [1,4,6,7] Conclusion: It is exposed, then, a case of HIV-induced MFS whose relationship has consistency, temporality, biological plausibility, coherence and analogy compatible with current literature.
Is Guillain-Barrè syndrome triggered by SARS-CoV-2? Case report and literature review
