Overlap of Bickerstaff encephalitis and Guillain-Barré syndrome in a patient with systemic lupus

Santos, Daniel P.A.; Spitz, Mariana; Oliveira, Perola; Barcia, Thiago; Silva, Rafael Souza da; Azevedo, Luiza Lopes de; Meilman, Claudio; Vasconcellos, Luiz Felipe Rocha; Lacativa, Clinete Sampaio; El-kadum, Jorge Noujaim

doi:10.1590/s0004-282x2009000500025

Cited by 5 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most cases had demyelinating variant. The seven cases of axonal variant from previous reports [13][14][15][16][17][18] and our case are summarized in Table 2. Most of the cases of GBS occurred in the early course of SLE and were treated with a variety of immunotherapy regimens.…”

Section: Discussionmentioning

confidence: 93%

Acute motor-sensory axonal neuropathy associated with systemic lupus erythematosus

Thakolwiboon

Sohn

2019

Baylor University Medical Center Proceedings

View full text Add to dashboard Cite

Systemic lupus erythematosus (SLE) is an autoimmune disease that involves multiple organs and is generally treated by immunosuppressive agents. Acute motor-sensory axonal neuropathy (AMSAN) is a variant of Guillain-Barr e syndrome. The standard therapies are intravenous immunoglobulin or plasmapheresis. An association between AMSAN and SLE is rarely reported. Herein, we describe a case of a 72-year-old man who presented with rapidly progressive paraparesis, dysesthesia, and joint pain with morning stiffness. Initially, he was diagnosed with AMSAN. Intravenous immunoglobulin was given without significant improvement. Subsequent studies indicated the diagnosis of SLE. Therefore, the patient was treated with intravenous methylprednisolone, cyclophosphamide, and then plasmapheresis. At 3 months, he improved from bedridden to wheelchair-bound. Our case demonstrates AMSAN as a rare initial manifestation that can lead to significant disability.

show abstract

Section: Discussionmentioning

confidence: 93%

Acute motor-sensory axonal neuropathy associated with systemic lupus erythematosus

Thakolwiboon

Sohn

2019

Baylor University Medical Center Proceedings

View full text Add to dashboard Cite

show abstract

“…AIDP [138] and AMAN [137] appear most frequently, although FS [139] and BBE [140] have also been reported. Other autoimmune diseases have also been implicated, including but not limited to: rheumatoid arthritis, inflammatory bowel disease, myasthenia gravis, Graves' disease [141] and Sjögren's syndrome [142].…”

Section: Autoimmune Diseasesmentioning

confidence: 99%

Infectious and noninfectious triggers in Guillain–Barré syndrome

Wakerley

Yuki

2013

Expert Review of Clinical Immunology

112

View full text Add to dashboard Cite

Guillain-Barré syndrome (GBS) is the commonest cause of acquired flaccid paralysis in the world and regarded by many as the prototype for postinfectious autoimmunity. Here the authors consider both infectious and noninfectious triggers of GBS and determine where possible what immunological mechanisms may account for this association. In approximately two-thirds of cases, an infectious trigger is reported in the weeks that lead up to disease onset, indicating that the host's response to infection must play an important role in disease pathogenesis. The most frequently identified bacteria, Campylobacter jejuni, through a process known as molecular mimicry, has been shown to induce cross-reactive anti-ganglioside antibodies, which can lead to the development of axonal-type GBS in some patients. Whether this paradigm can be extended to other infectious organisms or vaccines remains an important area of research and has public health implications. GBS has also been reported rarely in patients with underlying systemic diseases and immunocompromised states and although the exact mechanism is yet to be established, increased susceptibility to known infectious triggers should be considered most likely.

show abstract

“…The disease peaks during adolescence and in older age and appears to affect males more often than females ( 3 , 10 ). Fatal outcome has been reported ( 11 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Guillain-Barré Syndrome as Primary Presentation of Systemic Lupus Erythematosus (SLE-GBS) in a Teenage Girl

et al. 2022

View full text Add to dashboard Cite

Peripheral nervous system involvement accounts for fewer than 10% of SLE cases with neuropsychiatric manifestations. Guillain-Barré syndrome (GBS) as the presenting, major manifestation of pediatric SLE is extremely rare, and the best treatment approach is unknown. A 14-year-old, previously healthy female teenager developed classic features of GBS with ascending bilateral muscle weakness leading to respiratory insufficiency, associated with protein-cell dissociation in cerebro-spinal fluid, nerve root enhancement by MRI and reduction in compound muscle action potential amplitude. SLE was diagnosed serologically and histologically (lupus nephritis WHO class II). Despite immediate treatment with intravenous immunoglobulin (IVIg), methylprednisolone pulses and subsequently, rituximab, the patient required prolonged mechanical ventilation. She achieved full recovery following 14 PLEX treatments and two more rituximab infusions. Anti-dsDNA, C3, C4 and urinalysis normalized while anti-Smith and Sjögren antibodies persisted 15 months after disease onset, with no other lupus manifestations. Review of the literature revealed two pediatric cases of GBS at the onset of SLE and a third case with GBS 6 years after the diagnosis of SLE. Conventional GBS therapy may not be adequate to treat SLE-GBS. SLE should be included in the differential diagnosis of GBS. Importantly, treatment experiences and outcomes of such cases need be reported to inform future treatment recommendations.

show abstract

Overlap of Bickerstaff encephalitis and Guillain-Barré syndrome in a patient with systemic lupus

Cited by 5 publications

References 6 publications

Acute motor-sensory axonal neuropathy associated with systemic lupus erythematosus

Acute motor-sensory axonal neuropathy associated with systemic lupus erythematosus

Infectious and noninfectious triggers in Guillain–Barré syndrome

Case Report: Guillain-Barré Syndrome as Primary Presentation of Systemic Lupus Erythematosus (SLE-GBS) in a Teenage Girl

Contact Info

Product

Resources

About