Episodes of Guillain-Barré syndrome associated with the acute phase of HIV-1 infection and with recurrence of viremia

Abstract

We report a severe case of Guillain-Barré syndrome (GBS) characterized by flaccid areflexive tetraplegia and signs of autonomic instability related to acute HIV-1 infection, and the occurrence of relapse episodes coinciding with the detection of HIV-1 RNA in blood during the phase of irregular treatment with antiretroviral agents. The patient has been asymptomatic for 3 years and has an HIV-1 load below the limit of detection. The recurrence of GBS in this case may be related to alterations of the immunologic response caused by disequilibrium in the host-HIV relationship due to the increase in HIV-1 viremia.

Human immunodeficiency virus infection presenting as a fatal case of Guillain-Barré syndrome on a background of diabetes mellitus

“…[4][5][6] The observed very high fever in the last two days of admission in the patient may suggest an autonomic component in the presentation of GBS as demonstrated by González-Suárez et al [6] Though GBS has been associated with HIV but not commonly with diabetes mellitus. [7][8][9][10][11][12][13][14] It is yet to be reported in a patient with concomitant HIV infection and diabetes mellitus as we observed. HIV is thought to be directly associated with the onset of GBS at sero-conversion or in the chronic phase.…”

“…HIV is thought to be directly associated with the onset of GBS at sero-conversion or in the chronic phase. [7][8][9][10] We were unable to determine at what point in the infection GBS occurred in our patient, but without a prior diagnosis of HIV infection and the fact that the couple was discordant for HIV infection may suggest an acute HIV infection in our patient. The observation of diabetes mellitus was recent, a few days before hospital admission.…”

“…[3][4][5][6] HIV infection or diabetes mellitus occurring singly have not been associated with a different prognostic outcome as has been widely reported even among African populations. [8][9][10][11][12][13] The rate of progression of the disease in our patient was rather rapid with the outcome resulting in death. We believe that perhaps the combined existence of HIV infection and diabetes mellitus will explain the rapid progression of GBS in our patient and combined with the late recognition of the disease may be responsible for the fatal outcome of the disease.…”

“…[6] Human immunodeficiency virus (HIV) infection has also been associated with GBS either during seroconversion or in association with central nervous system (CNS) infection in the chronic phase. [7][8][9][10] Also, GBS has been reported as a presentation in association with diabetes mellitus in the setting of diabetic neuropathy, diabetic coma or recent elevation of blood sugar levels. [11][12][13][14] But no report of GBS in Nigeria occurring in the setting of both HIV and diabetes mellitus has been observed.…”

Guillain-Barré Syndrome with Fatal Outcome during HIV-1-Seroconversion: A Case Report

“…About 20% of patients experience gastroenteritis as the antecedent cause [1]. Since 1985, several cases of the disease among HIV-infected patients have been reported, with GBS occurring concomitantly with HIV seroconversion or during the initial phases of infection [3–10]. In fact, HIV infection is one of the most common causes of this syndrome in African countries, India, and other developing countries.…”