Guillain-Barré syndrome following a Type 2 leprosy reaction: A case report

Abstract

A 39-years-old male patient with previously treated borderline lepromatous (BL) leprosy, presented with paresthesia and dysesthesia in the feet and hands, associated with fever, arthralgia, and erythema nodosum during a Type-2 leprosy reaction (LR) episode. This evolved in 3 days to a flaccid tetraparesis with areflexia, with gait impairment, in addition to clinical signs of dysautonomia, such as tachycardia, tachydyspnea, and cranial nerve involvement. The nerve conduction study was compatible with an acute inflammatory demyelinating polyradiculoneuropathy and the cerebrospinal fluid (CSF) analysis confirmed an inflammatory pattern. The patient was treated with intravenous immunoglobulin, showing an important clinical improvement. This case describes the unusual association between leprosy and Guillain-Barré syndrome (GBS), emphasizing the importance of recognition of this condition.