A 3-year-old boy with Guillain–Barré syndrome and encephalitis associated with Mycoplasma pneumoniae infection

Hanzawa, Fumie; Fuchigami, Tatsuo; Ishii, Wakako; Nakajima, S; Kawamura, Yuki I.; Endo, Akihiko; Arakawa, Chuichi; Kohira, Ryutaro; Fujita, Yukihiko; Takahashi, Shori

doi:10.1016/j.jiac.2013.09.010

Cited by 15 publications

(11 citation statements)

References 21 publications

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“…It was interesting that none of the patients in our sample suffered from GBS, as this has been previously associated with M. pneumoniae infection. 2,10,11,33 For thoroughness we therefore checked our hospital information system for patients admitted with GBS during the study period. Nine patients were identified and serological tests for M. pneumoniae antibodies had been performed in eight of these.…”

Section: Discussionmentioning

confidence: 99%

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

et al. 2016

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Objective In this retrospective study, we aimed to assess frequency, types, and long-term outcome of neurological disease during acute Mycoplasma pneumoniae (M. pneumoniae) infection in pediatric patients. Materials and Methods Medical records of patients hospitalized with acute M. pneumoniae infection were reviewed. Possible risk factors were analyzed by uni- and multivariate regression. Patients with neurological symptoms were followed up by expanded disability status score (EDSS) and the cognitive problems in children and adolescents (KOPKJ) scale. Results Out of 89 patients, 22 suffered from neurological symptoms and signs. Neurological disorders were diagnosed in 11 patients: (meningo-) encephalitis (n = 6), aseptic meningitis (n = 3), transverse myelitis (n = 1), and vestibular neuritis (n = 1), 11 patients had nonspecific neurological symptoms and signs. Multivariate logistic regression identified lower respiratory tract symptoms as a negative predictor (odds ratio [OR] = 0.1, p < 0.001), a preexisting immune deficit was associated with a trend for a decreased risk (OR = 0.12, p = 0.058). Long-term follow-up after a median of 5.1 years (range, 0.6-13 years) showed ongoing neurological deficits in the EDSS in 8/18, and in the KOPKJ in 7/17. Conclusion Neurological symptoms occurred in 25% of hospitalized pediatric patients with M. pneumoniae infection. Outcome was often favorable, but significant sequels were reported by 45%.

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Section: Discussionmentioning

confidence: 99%

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

et al. 2016

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“…[2][3][4] It can also cause a wide array of extrapulmonary manifestations [5][6][7][8][9] and even lead to sequelae and disability, such as bronchi-ectasis, bronchiolitis obliterans, interstitial pulmonary fibrosis, and paralysis. 10,11 Clinically, corticosteroids have been used for refractory M. pneumoniae pneumonia and have a dramatic beneficial effect in both children and adults. 2,4,12 Clinicians must be cognizant of children with M. pneumoniae pneumonia at risk for developing refractory or serious illnesses and initiate steroid therapy in a timely fashion.…”

Section: Introductionmentioning

confidence: 99%

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

et al. 2015

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BACKGROUND: Corticosteroids have been used for refractory Mycoplasma pneumoniae pneumonia and have beneficial effects. The aim of this study was to identify the biomarkers for predicting refractory M. pneumoniae pneumonia in a timely fashion to initiate steroid therapy. METHODS: This was a prospective cohort study of children with M. pneumoniae pneumonia admitted to the Children's Hospital of Fudan University from September 2012 to August 2013. Lactate dehydrogenase (LDH) and other laboratory tests, including complete blood counts, C-reactive protein, erythrocyte sedimentation rate (ESR), alanine aminotransferase, aspartate aminotransferase, ␣-hydroxybutyrate dehydrogenase (HBDH), creatine kinase, and creatine kinase MB, were performed on admission. Based on the definition of refractory M. pneumoniae pneumonia, subjects were divided into 2 groups: refractory M. pneumoniae pneumonia and usual M. pneumoniae pneumonia.The diagnostic values of laboratory findings were analyzed. RESULTS: In total, 653 subjects were enrolled, including 300 in the refractory pneumonia group and 353 in the usual pneumonia group. There was no significant difference in sex distribution between the 2 groups. The average age in the refractory M. pneumoniae pneumonia group was greater than that in the usual M. pneumoniae pneumonia group. Compared with the usual pneumonia group, the refractory pneumonia group showed significantly higher levels of C-reactive protein, serum LDH, serum HBDH, serum alanine aminotransferase, serum aspartate aminotransferase, and neutrophils and higher ESRs. Logistic regression showed that age, LDH, and ESR were the significant factors in predicting refractory M. pneumoniae pneumonia. In addition, LDH and HBDH were strongly correlated, and receiver operating characteristic curve analysis showed that the area under the curve of LDH was 0.718 with a cutoff of 379 IU/L, that of ESR was 0.683 with a cutoff of 32.5 IU/L, and that of HBDH was 0.691 with a cutoff of 259.5 IU/L. CONCLUSIONS: Serum LDH can be used as a biomarker to predict refractory M. pneumoniae pneumonia at the early stage of hospitalization.

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“…Thus, the anti-Gal-C antibody might have been related to ADEM in the present case. In support of this, several clinical studies have reported that anti-Gal-C antibodies were sometimes detected in the serum of patients with immune-mediated encephalitis or ADEM ( 8 , 16 ). Samukawa et al reported that 4 of 25 ADEM patients were positive for anti-Gal-C antibodies, and that 3 of the 4 positive patients showed tetraparesis and motor-dominant axonal neuropathy ( 16 ).…”

Section: Discussionmentioning

confidence: 65%

“…Galactocerebroside (Gal-C) is a type of neutral glycosphingolipid that is localized in both the CNS and PNS as a component of myelin ( 5 , 6 ). The antibody to Gal-C is detected in the serum of some GBS patients, and it is also detected following post-infectious encephalopathy, especially that caused by Mycoplasma pneumoniae ( 7 , 8 ). We herein report case of recurrent GBS in a patient who was seropositive for anti-Gal-C antibodies.…”

Section: Introductionmentioning

confidence: 99%

An Adult Case of Recurrent Guillain-Barré Syndrome with Anti-galactocerebroside Antibodies

et al. 2018

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A 79-year-old woman with a history of Guillain-Barré syndrome (GBS) developed somnolence and tetraparesis after pneumonia. Based on clinical and laboratory findings, she was diagnosed with complications of acute inflammatory demyelinating polyneuropathy (AIDP) and acute disseminated encephalomyelitis (ADEM). Anti-galactocerebroside (Gal-C) IgG antibodies were detected in her serum. Cases of recurrent GBS in patients who are positive for this antibody are extremely rare. The anti-Gal-C IgG antibodies likely played an important role in the pathogenesis of the AIDP and ADEM.

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A 3-year-old boy with Guillain–Barré syndrome and encephalitis associated with Mycoplasma pneumoniae infection

Cited by 15 publications

References 21 publications

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

An Adult Case of Recurrent Guillain-Barré Syndrome with Anti-galactocerebroside Antibodies

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