Cardiovascular Complications of the Guillain-Barré Syndrome

Is a second cycle of immunoglobulin justified in axonal forms of Guillain-Barré syndrome?

“…The functional prognosis and the need for mechanical ventilation can be estimated upon admission with the application of different scores, though none of these scores was designed to predict refractoriness to treatment 17,18,19,20 . A quarter of the patients have severe forms, characterized by axonal compromise on EMG, bulbar and respiratory failure requiring artificial life support, and hemodynamic instability with risk of sudden death related to autonomic dysfunction 1,2,3,4,5,6,16 . .…”

“…Autonomic failure was considered present when the individual have had marked fluctuations in blood pressure and or heart rate, arrhythmias, profuse sweating or paralytic ileus 1,2,3,4,5,6,16 . IVIg was started as soon as the diagnosis was established at 0.4g/kg/day during 5 consecutive days (Sandoglobulin, CSI, Behring, Switzerland).…”

“…The severity of the syndrome was classified based on the Erasmus score 15 , need of mechanical ventilation and artificial nutrition thought nasogastric or nasoyeyunal tube because of bulbar involvement and the presence of dysautonomia 1,2,3,4,5,6,16 . Autonomic failure was considered present when the individual have had marked fluctuations in blood pressure and or heart rate, arrhythmias, profuse sweating or paralytic ileus 1,2,3,4,5,6,16 .…”

Guillain-Barré syndrome following heart transplantation complicated by myocardial infarction following treatment with IVIg

“…Several explanations for myocardial involvement have been postulated including cross-reactivity of antibodies to lactose-containing gangliosides on the heart as well as increased catecholamine levels and sensitivity. [2] 4. CONCLUSIONS GBS occurs less frequently in patients following transplantation than in the general population, and the most commonly reported inciting factor in the post-transplant population is infection with CMV.…”

“…Other possible clinical manifestations of this syndrome include respiratory failure, autonomic dysfunction, and rarely acute coronary syndromes and heart failure. [1,2] The most common inciting event in the general population is an infection with Campylobacter jejuni, found in 25%-50% of adult patients; however, multiple other infectious and noninfectious etiologies have been described. [1] Current understanding of the pathophysiology of this syndrome implicates molecular mimicry between microbial glycans and glycans present on the surface of nerve gangliosides.…”