Clinical profile and predictors for outcome in children presenting with Guillain–Barré syndrome

Singh, Sumit; Gupta, Nitin; Gupta, Arpita; Chandel, Anuragsingh; Waghela, Sneha; Saple, Pallavi

doi:10.4103/jfmpc.jfmpc_951_20

Cited by 4 publications

(6 citation statements)

References 22 publications

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“…In our study, the frequency of AIDP, AMAN and ASMAN was 61.7%, 29.4%, and 8.8%, respectively, which is similar to studies published from France, Korea and Karnataka. [11][12][13]15 Similar findings were present in studies done by Nasiri et al and Kalita et al where AIDP was more prevalent than AMAN among GBS patients. 17,25 Whereas in study done by Rangan et al AMAN was more prevalent than AIDP.…”

Section: Discussionsupporting

confidence: 80%

“…The findings were comparable to those of Tiwari et al and Singh et al who found that motor weakness in all four limbs as their presenting symptom respectively in 87% and 97% patients. 13,21 In our study 15.6% of patients had sensory involvement in the form of pain and tingling sensation in the bilateral lower limbs. These findings were comparable to those of study by Tiwari et al who found that 13% of patients had sensory involvement.…”

Section: Discussionmentioning

confidence: 44%

“…This is similar to study done by Singh et al where it was observed that mean duration to peak disability was 7.2 days. 13 In our cohort, all of the patients presented with symmetrical lower limb weakness that gradually progressed to involve bilateral upper limb as well. The findings were comparable to those of Tiwari et al and Singh et al who found that motor weakness in all four limbs as their presenting symptom respectively in 87% and 97% patients.…”

Section: Discussionmentioning

confidence: 69%

“…11,13 Mean age in Rangan et al study and Nasiri et al were 5.4 years and 5.7 years respectively. 16,17 Most studies show a male preponderance in GBS, including ours and a study done by Nasiri et al [11][12][13][14]17 Majority of cases were seen in monsoon season in our study. Similar findings were noted by Meshram et al in their study.…”

Section: Discussionmentioning

confidence: 89%

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Study of clinical profile and outcome in children aged 1-12 years presenting with Guillain Barre syndrome

Adhikari

Shinde

Siddhu

et al. 2023

Int J Contemp Pediatr

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Background: Guillain-Barré syndrome (GBS) is a group of clinical syndromes involving acute polyneuropathy secondary to an immune-mediated process. The aim of the research is to study clinical profile and outcome in children aged 1-12 years presenting with GBS. Methods: It is a prospective plus retrospective observational study (5-year retrospective + 18 months prospective). All cases of GBS admitted from January 2020-july 2021 were enrolled for the study and retrospective cases were taken from case record from January 2015 onwards in a tertiary care centre. Results: Total 45 children were enrolled. The male: female ratio was 1.64:1. Mean age at presentation was 6.3 years, in a range of 1.5 -11.5 years of age. History of antecedent illness prior to the occurrence of GBS was present in 93.3% patients with upper respiratory tract infection being most common seen in 53.3% patients. Following variants of GBS were seen on NCV study performed in 34 patients, the most common was AIDP in 46.7% patients, followed by AMAN in 22.2% subjects and AMSAN in 6.7% patients. All children presented with lower limb weakness which progressed to involve upper limbs. Other associated features like bulbar cranial nerve involvement, respiratory muscle weakness, sensory symptoms and autonomic disturbance (arrythmia, hypotension, tachycardia, bradycardia) was observed in 30,12,7,16 patients respectively. Out of the total 45 patients, 12 patients required mechanical ventilation. Conclusions: Male predominance seen in GBS. AIDP the most common subtype of GBS. Respiratory distress and autonomic instability were associated with greater severity of Hughes disability score. Factors associated with poor outcome were sensory symptoms, autonomic instability, respiratory distress and bulbar cranial nerve involvement.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 89%

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Study of clinical profile and outcome in children aged 1-12 years presenting with Guillain Barre syndrome

Adhikari

Shinde

Siddhu

et al. 2023

Int J Contemp Pediatr

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“…Trong các nghiên cứu của Tiwari và Seung cũng chỉ ra đây là yếu tố liên quan đến thở máy 12,15. Các nghiên cứu của Tiwari, Singh và Mohammad đưa ra các triệu chứng lâm sàng bao gồm tổng điểm MRC thấp, liệt hầu họng, liệt thần kinh sọ, rối loạn thần kinh thực vật liên quan đến tiên lượng bệnh nặng 9,12,14. Rối loạn thần kinh thực vật có khả năng thở máy cao gấp 8,8 lần so với trẻ không có tổn thương 14.…”

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Một số yếu tố liên quan tiên lượng bệnh nặng ở trẻ em mắc hội chứng Guillain - Barre

Phương,

Hùng,

Hương

2023

TCNCYH

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Một số yếu tố liên quan tiên lượng bệnh nặng ở trẻ em mắc hội chứng Guillain - Barre. Nghiên cứu quan sát 127 trẻ mắc hội chứng Guillain - Barre tại Bệnh viện Nhi Trung ương từ 7/2018 đến 6/2023. Tuổi trung bình 6,14 ± 0,37 tuổi, nam/nữ là 2,1/1. 13 trẻ thuộc nhóm nặng cần thở máy, 1 trường hợp tử vong (0,8%). 62,2% có yếu tố tiền nhiễm, sốt 36,2%, nhiễm khuẩn hô hấp 31,2%, rối loạn tiêu hoá 7,1%. Phân ly đạm tế bào gặp ở 72% bệnh nhân, 2 dạng tổn thương điện cơ thường gặp là mất myelin và tổn thương sợi trục chiếm tỷ lệ 31,7% và 41,3%. Yếu tố tiên lượng: sốt trước khởi bệnh, thời gian nhập viện ngắn, khởi phát có liệt hầu họng, điểm cơ lực lúc nhập viện thấp, rối loạn thần kinh thực vật, liệt thần kinh sọ, suy hô hấp, sốt trong quá trình điều trị, tăng bạch cầu, tăng protein phản ứng C, tăng tỷ lệ bạch cầu trung tính và bạch cầu lympho. Triệu chứng lâm sàng của hội chứng Guillain - Barre ở trẻ em rất đa dạng và không điển hình. Cần kết hợp lâm sàng và cận lâm sàng để đánh giá đầy đủ các yếu tố tiên lượng bệnh nặng. Nên chỉ định xét nghiệm công thức máu ngoại vi và protein phản ứng C với những bệnh nhân có lâm sàng gợi ý bệnh nặng. Phương pháp: Nghiên cứu quan sát 127 trẻ mắc hội chứng Guillain - Barre tại Bệnh viện Nhi Trung ương từ 7/2018 đến 6/2023. Kết quả: Phân tích 127 hồ sơ, tỷ lệ nam/nữ là 2,1/1, tuổi trung bình 6,14 ± 0,37 tuổi (16 tháng - 16 tuổi). 62,2% có yếu tố tiền nhiễm, nhiễm khuẩn hô hấp 31,2%, sốt 36,2%, rối loạn tiêu hoá 7,1%. Có 13/127 bệnh nhân thuộc nhóm nặng (Hughes > 4 điểm) cần hỗ trợ thở máy, 1 trường hợp tử vong (0,8%). Một số yếu tố liên quan đến tiên lượng bệnh nặng: có sốt trước khởi bệnh (p = 0,015), thời gian nhập viện ngắn (p = 0,0001), khởi phát có yếu cơ hầu họng (p = 0,013), điểm MRC lúc nhập viện thấp (p = 0,003), có rối loạn thần kinh thực vật (p = 0,0001), liệt thần kinh sọ (p = 0,026), suy hô hấp (p = 0,0001), sốt trong quá trình điều trị (p = 0,0001), tăng bạch cầu trong máu ngoại vi (p = 0,008), tăng CRP (C - reactive protein: protein phản ứng C) (p = 0,004), tăng NLR (Neutrophil lymphocyte ratio - tỉ số bạch cầu trung tính và bạch cầu lympho) (p = 0,009). Kết luận: Triệu chứng lâm sàng của hội chứng Guillain - Barre ở trẻ em rất đa dạng và không điển hình. Yếu tố tiên lượng bệnh nặng bao gồm có sốt trước khởi bệnh, thời gian nhập viện ngắn, khởi phát có yếu cơ hầu họng, điểm MRC lúc nhập viện thấp, có rối loạn thần kinh thực vật, liệt thần kinh sọ, sốt trong quá trình điều trị, tăng bạch cầu trong máu ngoại vi, tăng CRP và tăng NLR. Cần kết hợp lâm sàng và cận lâm sàng để đánh giá đầy đủ các yếu tố tiên lượng bệnh nặng. Nên chỉ định xét nghiệm công thức máu ngoại vi và CRP với những bệnh nhân có lâm sàng gợi ý bệnh nặng.

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Predictors of Treatment Outcome and Clinical Profile among Guillain- Barre Syndrome Patients in South India

Joseph,

Shrigiri

2023

RRCT

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Background: Guillain-Barre syndrome (GBS) is one of the principal causes of acute neuromuscular weakness and paralysis worldwide. Its clinic-epidemiological profile and factors influencing its treatment outcomes in developing countries are very minimally studied. Objective: The study aimed to study the risk factors, clinical presentation, management, and predictors of treatment outcomes among GBS patients admitted in two tertiary care hospitals. Materials and Methods: Medical records of 121 inpatients with GBS confirmed based on the Brighton criteria over the recent five-year period from June 2017 to May 2022 were examined. Assessment of the severity of GBS was done using the Hughes functional grading scale. Results: The mean age at onset was 36.8±18.9 years. The majority of the patients [82 (67.8%)] were males. Antecedent illnesses within 1 month of onset of GBS were present among 34 (28.1%) patients. The majority of them developed respiratory tract illnesses [13 (38.2%)]. Recurrent history of GBS was observed among 4 (3.3%) patients. The median time gap between the onset of antecedent illnesses and the onset of GBS was 5 days (IQR 3, 10). The most common symptom among GBS patients was the weakness of the muscles of the extremities [117 (96.7%)]. The pattern of progression of weakness among 53 (45.3%) of these patients was from the lower to upper limbs. The most common sign noted was hypotonia in 64 (52.9%) patients. Complications due to GBS were observed among 12 (9.9%) patients. The most common complication was respiratory distress in 11 (91.7%) patients, followed by autonomic dysfunctions in 8 (66.7%). Albuminocytological dissociation in cerebrospinal fluid was noted among 48 (39.7%) patients. The majority of patients in nerve conduction studies had acute inflammatory demyelinating polyneuropathy [61 (50.4%)]. The majority of the GBS patients [68 (56.2%)] were treated using intravenous immunoglobulin (IVIG). 95 (78.5%) patients improved with treatment at the time of discharge. In multivariable analysis, the absence of antecedent illnesses (p =0.029), Brighton’s diagnostic certainty levels 1 and 2 of GBS (p =0.024), and being kept on IVIG treatment (p =0.05) were associated with improvement in disease condition among the patients. Conclusion: Appropriate diagnosis of GBS using both clinical and laboratory evidence and providing appropriate treatment along with more supervision among GBS patients with a history of antecedent illnesses will help improve their prognosis at the time of discharge.

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Clinical profile and predictors for outcome in children presenting with Guillain–Barré syndrome

Cited by 4 publications

References 22 publications

Study of clinical profile and outcome in children aged 1-12 years presenting with Guillain Barre syndrome

Study of clinical profile and outcome in children aged 1-12 years presenting with Guillain Barre syndrome

Một số yếu tố liên quan tiên lượng bệnh nặng ở trẻ em mắc hội chứng Guillain - Barre

Predictors of Treatment Outcome and Clinical Profile among Guillain- Barre Syndrome Patients in South India

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