Genetics of Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): current knowledge and future directions

ABSTRACTGuillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF.

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Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy

10.1093/med/9780190667351.003.0026 ◽

2018 ◽

Author(s):

Pariwat Thaisetthawatkul ◽

Eric Logigian

Keyword(s):

Fetal Outcome ◽

Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽

Guillain Barre Syndrome ◽

Progressive Muscle Weakness ◽

Immune Mediated ◽

Guillain Barré Syndrome ◽

Viral Illness ◽

Life Threatening ◽

Depolarizing Agents ◽

Guillain Barré

Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are both immune-mediated diseases of the peripheral nervous system that typically present with symmetric, progressive muscle weakness, areflexia, and sensory symptoms or signs. GBS evolves rapidly with a nadir at 2–4 weeks usually with an antecedent viral illness, while CIDP progresses more slowly over months to years. GBS is sometimes complicated by life-threatening respiratory failure or dysautonomia. Onset of GBS and relapse of CIDP can occur during pregnancy or postpartum. But with appropriate supportive care and immunotherapy, maternal and fetal outcome in both conditions is typically excellent. The exception is fetal outcome in GBS triggered by maternal CMV or Zika infection transmitted to the fetus. Full-term vaginal delivery and regional anesthesia are preferred in maternal GBS and CIDP, but if C-section and general anesthesia are indicated, non-depolarizing agents such as succinylcholine should be avoided.

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Are CSF or serum ganglioside antibodies related to peripheral nerve demyelination in neuroborreliosis, Guillain-Barré syndrome, or chronic inflammatory demyelinating polyradiculoneuropathy?

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/bf02191559 ◽

1992 ◽

Vol 242 (2-3) ◽

pp. 122-126 ◽

Cited By ~ 8

Author(s):

Michael Weller ◽

Andreas Stevens ◽

Norbert Sommer ◽

Horst Wiethölter

Keyword(s):

Peripheral Nerve ◽

Chronic Inflammatory Demyelinating Polyradiculoneuropathy ◽

Guillain Barre Syndrome ◽

Guillain Barré Syndrome ◽

Ganglioside Antibodies ◽

Guillain Barré

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Guillain-Barré Syndrome due to Covid-19: A Review

10.5327/1516-3180.553 ◽

2021 ◽

Author(s):

Julia Carvalho Folly ◽

Lara Emanuelle Silva Reis ◽

Stella Maris Lins Terrena

Keyword(s):

English Language ◽

Viral Infections ◽

Current Knowledge ◽

Guillain Barre Syndrome ◽

Pubmed Database ◽

Guillain Barré Syndrome ◽

The Central Nervous System ◽

Guillain Barré ◽

Meta Analyses ◽

Clinical Pictures

Background: With the pandemic of SARS-CoV-2 virus spreading, there has been an increase in the dissemination of information relating the infection to neuromuscular involvement. Articles indicate an increase in cases of GuillainBarré Syndrome immediately or a few weeks after infection by the virus. Objectives: The present study aimed to gather the current knowledge disclosed in the literature about the onset of Guillain-Barré Syndrome (GBS) related to SARS-CoV-2 infection. Methods: The study design was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), using the Pubmed database, including articles in Portuguese and English language. Results: Articles that indicated an increase in cases of Guillain-Barré Syndrome dated to publications in April 2020 of cases analyzed since February of the same year. Histopathological analyses that identified the virus in the central nervous system of patients, associated with the detection of anti-anglioside antibodies of the anti-GM1, anti-GD1a and anti-GD1b types in the patients analyzed, represent important findings about GBS associated with Covid-19. Pro-inflammatory cytokines present in the immune response as a result of SARS-COV-2 have been associated with the triggering of neuronal injury. In patients analyzed we observed the manifestation of symptoms between 5 and 21 days after Covid-19 infection, similar to the reported GBS interval after other viral infections. Conclusion: The clinical pictures of patients affected by Covid-19 suggest an intense possible relating between infection by the new coronavirus and autoimmune neuromuscular conditions. Further studies are needed on this association, which has not yet been clarified.

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