HyperCKemia in Guillain-Barré Syndrome

2020 ◽  
Vol 83 (4) ◽  
pp. 415-420
Author(s):  
Seok-Jin Choi ◽  
Yoon-Ho Hong ◽  
Jun-Soon Kim ◽  
Je-Young Shin ◽  
Jung-Joon Sung
Keyword(s):  
Creatine Kinase ◽  
South Korea ◽  
Clinical Features ◽  
Serum Creatine Kinase ◽  
Guillain Barre Syndrome ◽  
Teaching Hospitals ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Male Sex ◽  
Guillain Barré

The aim of the present study was to investigate the frequency and clinical features of Guillain-Barré syndrome (GBS) with hyperCKemia. We retrospectively identified 139 patients with GBS at 2 teaching hospitals in South Korea. We excluded patients with Miller-Fisher syndrome (n = 19), acute bulbar palsy (n = 3), and those whose serum creatine kinase (CK) levels were not measured (n = 45). Twelve of 72 patients (16.7%) had transient hyperCKemia, defined as serum CK ≥300 IU/L. The frequency of male sex and non-demyelinating electrodiagnostic features were higher in patients with hyperCKemia than those without. Transient hyperCKemia, occasionally seen in patients with GBS may be associated with the non-demyelinating subtype.

scholarly journals Clinical features of Guillain–Barré syndrome patients with elevated serum creatine kinase levels

2020 ◽  
Author(s):  
Takafumi Hosokawa ◽  
Hideto Nakajima ◽  
Taiki Sawai ◽  
Yoshitsugu Nakamura ◽  
Eri Sano ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Clinical Features ◽  
Axonal Neuropathy ◽  
Elevated Serum ◽  
Serum Creatine Kinase ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Conduction Failure ◽  
Electrophysiological Examination ◽  
Guillain Barré

Abstract Background: It is not well defined whether Guillain–Barré syndrome (GBS) patients with elevated serum creatine kinase (CK) levels have characteristic clinical features and are related to the subgroups of GBS. Methods: We retrospectively studied 51 consecutive patients with GBS, who visited our hospital, and compared clinical, laboratory and electrophysiological findings between patients with and without elevated CK levels. Results: Of 51 patients, 14 patients (27%) showed an elevation of serum CK levels. When compared with patients with the normal CK levels, the ratios of male, antecedent infections, and anti-GM1 antibody positivity were significantly higher in patients with elevated CK levels. The ratios of hypoesthesia, cranial nerve involvement, and urinary retention were significantly less in patients with elevated CK levels. There were no significant differences in disability at peak between two groups. In the electrophysiological examination, sensory nerve abnormalities were not observed. Although some patients with elevated CK levels showed prolongation of distal motor latencies (DMLs) and increase of durations in the initial examination, development of the prolongation of DMLs and increase of durations was not observed in the follow-up examinations. The findings were consistent with acute motor axonal neuropathy (AMAN) with reversible conduction failure (RCF) but not acute inflammatory demyelinating polyneuropathy (AIDP). Conclusions: The results suggest that the GBS patients with elevated CK levels represent not a group of AIDP but a group of AMAN with axonal degeneration or RCF even though the initial electrophysiological examination shows AIDP pattern. Key words: Creatine kinase, Guillain-Barré syndrome, AIDP, AMAN, reversible conduction failure

scholarly journals Clinical features of Guillain–Barré syndrome patients with elevated serum creatine kinase levels

2020 ◽  
Author(s):  
Takafumi Hosokawa ◽  
Hideto Nakajima ◽  
Taiki Sawai ◽  
Yoshitsugu Nakamura ◽  
Eri Sano ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Clinical Features ◽  
Axonal Neuropathy ◽  
Elevated Serum ◽  
Sensory Nerve ◽  
Serum Creatine Kinase ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Electrophysiological Examination ◽  
Guillain Barré

Abstract Background: It is not well defined whether Guillain–Barré syndrome (GBS) patients with elevated serum creatine kinase (CK) levels have characteristic clinical features and are related to the subgroups of GBS. Methods: We retrospectively studied 51 consecutive patients with GBS, who visited our hospital, and compared clinical, laboratory and electrophysiological findings between patients with and without elevated CK levels. Results: Of 51 patients, 14 patients (27%) showed an elevation of serum CK levels. When compared with patients with the normal CK levels, the ratios of male, antecedent infections, and anti-GM1 antibody positivity were significantly higher in patients with elevated CK levels. The ratios of hypoesthesia, cranial nerve involvement, and urinary retention were significantly less in patients with elevated CK levels. There were no significant differences in disability at peak between two groups. In the electrophysiological examination, sensory nerve abnormalities were not observed. Although some patients with elevated CK levels showed prolongation of distal motor latencies (DMLs) and increase of durations in the initial examination, development of the prolongation of DMLs and increase of durations was not observed in the follow-up examinations. The findings were consistent with acute motor axonal neuropathy (AMAN) with reversible conduction failure (RCF) but not acute inflammatory demyelinating polyneuropathy (AIDP). Conclusions: The results suggest that the GBS patients with elevated CK levels represent not a group of AIDP but a group of AMAN with axonal degeneration or RCF even though the initial electrophysiological examination shows AIDP pattern.

scholarly journals Clinical features of Guillain–Barré syndrome patients with elevated serum creatine kinase levels

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Takafumi Hosokawa ◽  
Hideto Nakajima ◽  
Taiki Sawai ◽  
Yoshitsugu Nakamura ◽  
Eri Sano ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Clinical Features ◽  
Elevated Serum ◽  
Serum Creatine Kinase ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals Guillain-Barré syndrome and related diseases after influenza virus infection

2019 ◽  
Vol 6 (4) ◽  
pp. e575 ◽  
Author(s):  
Masaki Yamana ◽  
Motoi Kuwahara ◽  
Yuta Fukumoto ◽  
Keisuke Yoshikawa ◽  
Kazuo Takada ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Clinical Features ◽  
Cranial Nerve ◽  
Influenza Infection ◽  
Influenza Virus Infection ◽  
Guillain Barre Syndrome ◽  
Fisher Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ObjectiveWe examined the clinical and serologic features of Guillain-Barré syndrome (GBS)-related diseases (GBSRDs), including GBS, Fisher syndrome (FS), and Bickerstaff brainstem encephalitis (BBE), after influenza virus infection (GBSRD-I) to reveal potential underlying autoimmune mechanisms.MethodsWe retrospectively investigated the presence of antiglycolipid antibodies against 11 glycolipids and the clinical features of 63 patients with GBSRD-I. Autoantibody profiles and clinical features were compared with those of 82 patients with GBSRDs after Campylobacter jejuni infection (GBSRD-C).ResultsThe anti-GQ1b seropositivity rate was significantly higher, whereas the GM1 and GD1a seropositivity rates were significantly lower in GBSRD-I compared with GBSRD-C. Anti-GQ1b and anti-GT1a were the most frequently detected antiglycolipid antibodies in GBSRD-I (both 15/63, 24%). Consequently, FS was more frequent in GBSRD-I than GBSRD-C (22% vs 9%, p < 0.05). In addition, as for GBS, cranial nerve deficits, sensory disturbances, and ataxia were more frequent in the cases after influenza infection (GBS-I) than in those after C. jejuni infection (GBS-C) (46% vs 15%, 75% vs 46%, and 29% vs 4%, respectively; all p < 0.01). Nerve conduction studies revealed acute inflammatory demyelinating polyneuropathy (AIDP) in 60% of patients with GBS-I but only 25% of patients with GBS-C (p < 0.01).ConclusionsAnti-GQ1b antibodies are the most frequently detected antibodies in GBSRD-I. Compared with GBS-C, GBS-I is characterized by AIDP predominance and frequent presence of cranial nerve involvement and ataxia.

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 triggered by surgery in a Chinese population: a multicenter retrospective study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiaoyu Gong ◽  
Shuping Liu ◽  
Yin Liu ◽  
Jiajia Yao ◽  
Xiujuan Fu ◽  
...  
Keyword(s):  
Clinical Features ◽  
Orthopedic Surgery ◽  
Southern China ◽  
Axonal Neuropathy ◽  
Trigger Factor ◽  
Guillain Barre Syndrome ◽  
Initial Symptoms ◽  
Guillain Barré Syndrome ◽  
Potential Trigger ◽  
Guillain Barré

Abstract Background Surgery is a potential trigger of Guillain-Barré syndrome (GBS), a disorder which leads to an autoimmune-mediated attack of peripheral nerves. The present study was designed to explore clinical features of post-surgical GBS compared with those of general GBS in order to provide better clinical advice to patients undergoing surgery. Methods The medical records of GBS patients who were seen at 31 tertiary hospitals in southern China between January 1, 2013 and September 30, 2016 were retrospectively analyzed. Post-surgical GBS was defined as symptoms of GBS within 6 weeks after surgery. Clinical features of post-surgical GBS are described and are compared with general GBS. Results Among the 1001 GBS patient cases examined in this study, 45 (4.5%) patient cases exhibited symptoms of GBS within 6 weeks of undergoing surgery. Within this group, 36 (80.0%) patients developed initial symptoms of limb weakness. The average interval between surgery and symptom onset was 13.31 days. The most common type of surgery which triggered GBS was orthopedic surgery, followed by neurological surgery. Compared to general GBS, post-surgical GBS was characterized by a higher proportion of severe patients (Hughes functional grading scale (HFGS) score ≥ 3) upon admission and at nadir, higher HFGS scores at discharge, and longer hospital stays. Post-surgical GBS patients also had a significantly higher frequency of the acute motor axonal neuropathy subtype (37.9 vs. 14.2, respectively; P = 0.001). Conclusion Surgery is probably a potential trigger factor for GBS, especially orthopedic surgery. Infections secondary to surgery may play a role. The possibility of preceding (post-operative) infections was not excluded in this study. Clinical presentation of post-surgical GBS is characterized by a more severe course and poorer prognosis, and should be closely monitored. Trial registration chicTR-RRc-17,014,152.

scholarly journals Clinical features and prognosis with Guillain-Barré syndrome

2011 ◽  
Vol 14 (2) ◽  
pp. 98 ◽  
Author(s):  
Sinan Akbayram ◽  
Cihangir Akgün ◽  
Refah Sayin ◽  
Mehmet-Selçuk Bektas ◽  
Murat Dogan ◽  
...  
Keyword(s):  
Clinical Features ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré
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