scholarly journals Serum neurofilament light chain predicts long-term prognosis in Guillain-Barré syndrome patients

2020 ◽  
Author(s):  
Lorena Martín-Aguilar ◽  
Pol Camps-Renom ◽  
Cinta Lleixà ◽  
Elba Pascual-Goñi ◽  
Jordi Diaz-Manera ◽  
...  
Keyword(s):  
Light Chain ◽  
High Specificity ◽  
Guillain Barre Syndrome ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Fisher Syndrome ◽  
Baseline Serum ◽  
Guillain Barré Syndrome ◽  
One Year ◽  
Guillain Barré

ABSTRACTObjectiveTo study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS).MethodsWe measured NfL using SiMoA in serum (98 samples) and CSF (24 samples) of GBS patients prospectively included in the International GBS Outcome Study (IGOS) in Spain and compared them with controls (HC). We performed multivariable regression to analyze the association between sNfL levels and functional outcome at one year.ResultsGBS patients had higher NfL levels than HC in serum (55.49pg/mL vs 9.13pg/mL, p<0,0001) and CSF (1308.5pg/mL vs 440.24pg/mL, p=0.034). Patients with preceding diarrhea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90pg/mL vs 47.86pg/mL vs 38.02pg/mL, p=0.016). sNfL levels correlated with GDS and R-ODS scales. Patients with pure motor variant and Miller- Fisher syndrome showed higher sNfL levels than patients with sensory-motor GBS (162.18pg/mL vs 95.50pg/mL vs 38.02pg/mL; p=0.025). AMAN patients had higher sNfL levels than other variants (190.55pg/mL vs 46.79pg/mL, p=0.013). sNfL returned to normal levels at one year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14-2.40, p=0.009) and lower R-ODS (β −2.60, 95% β −4.66-(−0.54), p=0.014) at one year. Cut-off points predicting clinically relevant outcomes at one year with high specificity were calculated: inability to walk independently (>319pg/mL), inability to run (>248pg/mL) and ability to run (<34pg/mL).ConclusionBaseline sNfL levels are increased in patients with GBS, they are associated with disease severity and axonal variants and they have an independent prognostic value in GBS patients.

scholarly journals Serum neurofilament light chain predicts long-term prognosis in Guillain-Barré syndrome patients

2020 ◽  
Vol 92 (1) ◽  
pp. 70-77
Author(s):  
Lorena Martín-Aguilar ◽  
Pol Camps-Renom ◽  
Cinta Lleixà ◽  
Elba Pascual-Goñi ◽  
Jordi Díaz-Manera ◽  
...  
Keyword(s):  
Single Molecule ◽  
Light Chain ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Fisher Syndrome ◽  
Baseline Serum ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ObjectiveTo study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS).MethodsWe measured NfL in serum (98 samples) and cerebrospinal fluid (CSF) (24 samples) of patients with GBS prospectively included in the International GBS Outcome Study (IGOS) in Spain using single-molecule array (SiMoA) and compared them with 53 healthy controls (HCs). We performed multivariable regression to analyse the association between sNfL levels and functional outcome at 1 year.ResultsPatients with GBS had higher NfL levels than HC in serum (55.49 pg/mL vs 9.83 pg/mL, p<0.0001) and CSF (1308.5 pg/mL vs 440.24 pg/mL, p=0.034). Patients with preceding diarrhoea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90 pg/mL vs 47.86 pg/mL vs 38.02 pg/mL, p=0.016). sNfL levels correlated with Guillain-Barré Syndrome Disability Score and Inflammatory Rasch-built Overall Disability Scale (I-RODS) at every timepoint. Patients with pure motor variant and Miller Fisher syndrome showed higher sNfL levels than patients with sensorimotor GBS (162.18 pg/mL vs 95.50 pg/mL vs 38.02 pg/mL, p=0.025). Patients with acute motor axonal neuropathy cute motor axonal neuropathy had higher sNfL levels than other variants (190.55 pg/mL vs 46.79 pg/mL, p=0.013). sNfL returned to normal levels at 1 year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14 to 2.40, p=0.009) and lower I-RODS (β −2.60, 95% CI −4.66 to −0.54, p=0.014) at 1 year. Cut-off points predicting clinically relevant outcomes at 1 year with high specificity were calculated: inability to walk independently (>319 pg/mL), inability to run (>248 pg/mL) and ability to run (<34 pg/mL).ConclusionBaseline sNfL levels are increased in patients with GBS, are associated with disease severity and axonal variants and have an independent prognostic value in patients with GBS.

scholarly journals Increased serum neurofilament light chain concentration indicates poor outcome in Guillain-Barré syndrome

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Patrick Altmann ◽  
Desiree De Simoni ◽  
Alexandra Kaider ◽  
Birgit Ludwig ◽  
Jakob Rath ◽  
...  
Keyword(s):  
Light Chain ◽  
Guillain Barre Syndrome ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Poor Outcome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Ratio and index of Neurofilament light chain indicate its origin in Guillain‐Barré Syndrome

2020 ◽  
Vol 7 (11) ◽  
pp. 2213-2220
Author(s):  
Peter Körtvelyessy ◽  
Jens Kuhle ◽  
Emrah Düzel ◽  
Stefan Vielhaber ◽  
Christian Schmidt ◽  
...  
Keyword(s):  
Light Chain ◽  
Guillain Barre Syndrome ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Guillain–Barré Syndrome in COVID-19—The Potential Role of NCAM-1 and Immunotherapy

BioMed ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 80-92
Author(s):  
Krzysztof Laudanski ◽  
Aleksandra Yakhkind ◽  
Mariana Restrepo ◽  
Lindsay Draham ◽  
Adam Edward Lang
Keyword(s):  
Immune System ◽  
Guillain Barre Syndrome ◽  
System Response ◽  
Healthy Individuals ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Immune System Activation ◽  
Guillain Barré Syndrome ◽  
Acute Polyneuropathy ◽  
Guillain Barré

Coronavirus disease 2019 (COVID-19) interacts with the nervous system directly and indirectly by affecting the activation of the immune system. Guillain–Barré syndrome (GBS) is triggered by an inappropriate immune system activation that overlaps with the neurotoxic mechanism of an invading pathogen. Here, we discuss the complexity of an abnormal immune system response leading to the generation of autoimmunity in the setting of acute viral infection. A 67-year-old male patient with COVID-19 developed a sensory motor acute polyneuropathy with respiratory failure. Several serum inflammatory and neurodegeneration markers were collected during hospital days 1, 3, 8, and 67 and compared to healthy individuals. Neural cell adhesion molecule 1 (NCAM-1) and neurofilament light chain (NfL) values were highly variable when compared to healthy individuals, but not to the reference COVID-19 group. We focused our attention on NCAM-1 as a possible target for antibodies directed at COVID-19 in silico.

scholarly journals Post-Infectious Guillain–Barré Syndrome Related to SARS-CoV-2 Infection: A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  
Keyword(s):  
Single Case ◽  
Case Reports ◽  
Case Series ◽  
Guillain Barre Syndrome ◽  
Response To Treatment ◽  
Comprehensive Overview ◽  
Fisher Syndrome ◽  
Immunomodulating Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.

scholarly journals Guillain–Barré syndrome and Fisher syndrome: Case definitions and guidelines for collection, analysis, and presentation of immunization safety data

Vaccine ◽  
2011 ◽  
Vol 29 (3) ◽  
pp. 599-612 ◽  
Author(s):  
James J. Sejvar ◽  
Katrin S. Kohl ◽  
Jane Gidudu ◽  
Anthony Amato ◽  
Nandini Bakshi ◽  
...  
Keyword(s):  
Safety Data ◽  
Guillain Barre Syndrome ◽  
Case Definitions ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals An Overlapping Case of Miller Fisher Syndrome and the Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome

2020 ◽  
Author(s):  
Hélio Martins ◽  
Joana Mendonça ◽  
David Paiva ◽  
Carlos Fernandes ◽  
Jorge Cotter
Keyword(s):  
Miller Fisher Syndrome ◽  
Guillain Barre Syndrome ◽  
Magnetic Resonance Angiogram ◽  
Blurred Vision ◽  
Fisher Syndrome ◽  
Medicine Department ◽  
Neurological Improvement ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Head Computed Tomography

A 55 years-old Caucasian male presented initially in the emergency room reporting myalgia, chills and fever. Physical exam and laboratory tests were unremarkable and he was discharged with symptomatic care. He returned to our ER two weeks later reporting dizziness, loss of balance, blurred vision, mild dysarthria and bilateral hand paresthesia. On examination he presented complete bilateral ophthalmoplegia, mild dysarthria, left finger-to-nose dysmetria, ataxia, areflexia and bilateral hand hypoesthesia without fever. Blood tests and head computed tomography were normal. The patient was admitted to the Internal Medicine department. On second day inwards the patient presented dysphagia. Head magnetic resonance angiogram showed no signs of ischemia or vascular disease and a lumbar puncture was performed but no pleocytosis, albumin-cytological dissociation or hypoglycorrhachia was present. Despite the normal results we suspected of a Guillain–Barré syndrome variant, and started treatment with intravenous immunoglobulin (IVIG) in a dose of 400mg per kilogram and continued for five days with immediate neurological improvement. We present a rare overlapping case of Miller Fisher syndrome and Pharyngeal-Cervical-Brachial variant of Guillain–Barré syndrome.

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