Guillain‐Barré syndrome associated with inappropriate secretion of antidiuretic hormone following SARS‐CoV‐2 infection: A case‐report

Santoro, Carlo; Guerra, Tommaso; D’Errico, Eustachio; Fraddosio, Angela; Lapenna, Francesca; Introna, Alessandro; Trojano, María

doi:10.1002/ccr3.4667

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…This may yield interesting results to determine need for ICU, discharge planning, and follow-up 20,21 . The patient with a history of hyponatremia due to systemic or neurological disease is more likely to have hyponatremia after the onset of GBS, since a small trigger may be enough to develop a new autonomic dysfunction even after a long time and lead to a worse prognosis in their next illness 22 .…”

Section: Discussionmentioning

confidence: 99%

Guillain-Barre syndrome with hyponatremia, more than a simple finding

Martínez-Piña,

Medina-Gómez,

García-Hernández

et al. 2023

RMN

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Introduction: Hyponatremia occurs in 21-48% of patients with Guillain-Barre syndrome (GBS). However, little is known about the clinical implications in GBS. Materials and methods: In this observational, cross-sectional study, of patients diagnosed with GBS was conducted. Information used included: demographic clinical variables, cerebrospinal fluid (CSF) results, and nerve conduction studies. Patients with sodium levels < 135 meq/L in laboratory studies on admission and before treatment were considered to have hyponatremia. We defined good functional prognosis as the presence of independent gait (Hughes ≤ 2 points) at 3 months of follow-up. Results: Two hundred and twelve patients were initially screen and 31 (14.6%) presented hyponatremia; male gender was predominant with 72%, mean age was 45.9 ± 16 years, mean Modified Medical Research Council (MRC) score was 30.1 ± 17 points, invasive mechanical ventilation requirement was 32%, and the presence of dysautonomia 32%. One hundred and eighty-two nerve conduction studies, and 165 CSF cytochemical samples were collected. In the comparative analyses between the patients with hyponatremia versus without hyponatremia, we observed significant differences in mean age (50.4 ± 14.9 vs. 43.8 ± 16.3, p = 0.03), days of hospitalization (median) vs. 7 [IQR = 5-12] p = 0.03), dysautonomia (54.8% vs. 28.2%, p = 0.006), protein levels (mgs/dL) in CSF (median) (105 vs. 39 , p ≤ 0.001), and acute inflammatory demyelinating polyneuropathy (AIDP) variant (70.4% vs. 42%, p = 0.011). There was no significant finding in recovery of independent gait at 3 months (34.6% vs. 42.6%, p = 0.51). Conclusion: About 14% of patients with GBS presented with hyponatremia in our series and is associated with presence of dysautonomia, AIDP variant, elevated CSF protein levels and a greater number of days of hospital stay but did not impact functional prognosis.

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Section: Discussionmentioning

confidence: 99%

Guillain-Barre syndrome with hyponatremia, more than a simple finding

Martínez-Piña,

Medina-Gómez,

García-Hernández

et al. 2023

RMN

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Hyponatremia in Guillain-Barre Syndrome: A Review of Its Pathophysiology and Management

Netto,

Chandrahasa,

Koshy

et al. 2024

Can. J. Neurol. Sci.

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Guillain-Barre syndrome (GBS) is the commonest cause of acute polyradiculoneuropathy that requires hospitalization. Many of these patients experience systemic and disease-related complications during its course. Notable among them is hyponatremia. Though recognized for decades, the precise incidence, prevalence, and mechanism of hyponatremia in GBS are not well known. Hyponatremia in GBS patients is associated with more severe in-hospital disease course, prolonged hospitalization, higher mortality, increased costs, and a greater number of other complications in the hospital and worse functional status at 6 months and at 1 year. Though there are several reports of low sodium associated with GBS, many have not included the exact temporal relationship of sodium or its serial values during GBS thereby underestimating the exact incidence, prevalence, and magnitude of the problem. Early detection, close monitoring, and better understanding of the pathophysiology of hyponatremia have therapeutic implications. We review the complexities of the relationship between hyponatremia and GBS with regard to its pathophysiology and treatment.

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Guillain‐Barré syndrome associated with inappropriate secretion of antidiuretic hormone following SARS‐CoV‐2 infection: A case‐report

Abstract: In a system already preconditioned by previous damage, as results of the cytokine release syndrome complicating the COVID‐19 disease, a small trigger may be sufficient to develop a SIADH complicating a GBS, even without a poor outcome.

Cited by 2 publications

References 7 publications

Guillain-Barre syndrome with hyponatremia, more than a simple finding

Guillain-Barre syndrome with hyponatremia, more than a simple finding

Hyponatremia in Guillain-Barre Syndrome: A Review of Its Pathophysiology and Management

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