A clinical and pathological study of Guillain-Barré syndrome with treatment-related fluctuations
10.3760/cma.j.issn.1006-7876.2017.03
- VernacularTitle:治疗相关波动性吉兰-巴雷综合征的临床和病理特点
- Author:
Qinzhou WANG
;
Wei LI
;
Dong ZHANG
;
Yuying ZHAO
;
Tingjun DAI
;
Chuanzhu YAN
- Keywords:
Guillain-Barre syndrome;
Fluctuations;
Recurrence;
Pathological characteristics
- From:
Chinese Journal of Neurology
2017;50(3):中插1-中插5
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical and pathological features of Guillain-Barré syndrome with treatment-related fluctuations ( GBS-TRF ).Methods Clinical data were obtained from medical records of patients with GBS-TRF during the period 1999 to 2014 in our Hospital.Sural nerve specimens were collected and summarized retrospectively ( two cases ).Results Eight of 868 cases with GBS had at least one TRF including three chronic hepatitis B patients.The onset of disease was ranged in age from six to 63 years, averaging 34 years.It is more common in men than in women in a ratio of seven:one.Triggering infections occurred in three patients.The initial symptom included weakness of the lower limbs ( five cases ) and upper extremities ( three cases ).Sensory symptom was presented in six patients.Five patients had associated respiratory paralysis.None of them had cranial nerve palsy or autonomic dysfunction.Five patients had two attacks , one had three attacks and two had six attacks.The interval between attacks ranged between 14 days and 46 days ( mean 23 days ).The striking pathologic finding was the presence of sectional selective nerve fiber degeneration ( SNFD ) with evidence of demyelination.Conclusions Patients with GBS-TRF shows similar onset age , preceding infection , cerebrospinal fluid findings, and electrophysiologic characteristics comparing to patients with GBS ,while there are more male patients than female patients.SNFD found in sural nerve biopsy reveals ischemic neuropathy , which predicts that injury of arterioles might play an important role in the pathogenesis of GBS -TRF.
