Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil

Abstract

Background: Guillain-Barré syndrome (GBS) is currently the most common cause of acute flaccid paralysis worldwide. Risk factors for GBS include previous viral or bacterial infections or vaccination. Recently, an outbreak of Zika virus led to an outbreak of GBS in Latin America, mostly in Brazil, concomitant to continuous circulation of dengue virus serotypes. However, there is no study about cytomegalovirus (CMV) infection as a risk for GBS in Brazil. Objectives: In this study, we report a series of cases of GBS with the aim of determining the prevalence of CMV and the characteristics associated with the infection. Methods: A cohort of 111 GBS cases diagnosed between 2011 and 2017 in Natal, northeastern Brazil, was studied. Presence of CMV IgM antibodies was determined by means of electrochemiluminescence. The analysis was performed considering CMV infection status and the clinical outcome. Results: We found seroprevalence of 15.3% (n = 17) for CMV. CMV patients were younger (26 vs. 40; p = 0.016), with no apparent gastrointestinal (p = 0.762) or upper respiratory infections (p = 0.779) or sensory loss (p = 0.03). They presented more often with a classic GBS sensorimotor variant (p = 0.02) and with a demyelinating pattern in electrophysiological studies (p < 0.001). Conclusion: In Brazil, the clinical-epidemiological profile of GBS associated with CMV infection is similar to that described in other countries. Better understanding of the relationship between infectious processes and GBS is a key component of the research agenda and assistance strategy for global health initiatives relating to peripheral neuropathic conditions.

Guillain-barré syndrome and sars-cov2 corona virus. Vaccinate or get infected with covid? What poses less risk?

“…The sources of evidence, even with a large volume of publications, are still poor. With the current data, an association between COVID-19 infection and Guillain-Barré syndrome cannot be assumed, nor between vaccination against SARS-COV2 and Guillain-Barré syndrome; In both cases, however, if cause-effect existed, the pathophysiological mechanism would be the same, by means of cross-immunity due to the similarity between a sequence of the antigenic proteins of the virus and the gangliosides or other regions of the peripheral nerve [39,40]. It is striking, however, at the observational level that we are not facing a Guillain-Barré syndrome pandemic as would be expected if it were a strong association, either secondary to an infection as prevalent as COVID19, or secondary to a vaccination that in some countries borders on proportions close to 100%.…”

A novel approach to identify cross-identity peptides between Epstein-Barr virus and central nervous system proteins in Guillain-Barré syndrome and multiple sclerosis

“…Some studies show a higher frequency of viral infections before the onset of AIDP (4–6), though not yet associated with a known autoimmune antigen. As an autoimmune disease, losing immune tolerance to self-antigens may play a vital role in developing GBS (3,7).…”

“…though not yet associated with a known autoimmune antigen. As an autoimmune disease, losing immune tolerance to self-antigens may play a vital role in developing GBS (3,7).…”