Guillain‐Barré syndrome in the elderly

Perić, Stojan; Berisavac, Ivana; Tamaš, Olivera; Rajić, Sonja; Babic, Milica; Cvijanović, Milan; Dominović-Kovačević, Aleksandra; Basta, Ivana; Beslac-Bumbasirevic, Ljiljana; Lavrnić, Dragana

doi:10.1111/jns.12163

Cited by 18 publications

(17 citation statements)

References 31 publications

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“…GBS could occur at any age. In this study, we found that the disease progression in the elderly patients was slower, which was contradictory to Winner et al [7] and Peric et al, [9] who found that the time from onset of disease until admission/nadir was similar in the elderly patients and nonelderly patients. However, the disease severity of patients in the 2 groups showed no significant difference in the MRC score, HFGS score, severe type, and proportion of mechanical ventilation in our study.…”

Section: Discussioncontrasting

confidence: 99%

“…This finding was consistent with the results of Winner et al [7] in UK, which found that the severity of disease was similar between elderly and nonelderly adults. [7] However, our finding was contradictory to the results of Peric et al [9] in Eastern Europe, which found that elderly patients had more severe disease. In this study, the disease progression and the severity of disease of elderly GBS patients were different from other countries’ findings, and it may be the peculiar feature of elderly GBS in China.…”

Section: Discussioncontrasting

confidence: 99%

“…[5,6] In addition, studies have shown that elderly patients with GBS have more severe disease, less involvement of cranial nerve, more axonal damage, and slower recovery; however, the results of different studies show variation. [7–9] Also, some studies have demonstrated that old age was an important factor in predicting poor prognosis of GBS besides the severity of the disease. [10–12] The aim of this study was to explore the clinical features and short-term prognosis of elderly patients with GBS through a retrospective study.…”

Section: Introductionmentioning

confidence: 99%

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The clinical characteristics and short-term prognosis in elderly patients with Guillain–Barré syndrome

Zhang

Wu²,

Shen³

et al. 2017

Medicine

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To investigate the clinical characteristics and short-term prognosis of elderly patients with Guillain–Barré syndrome (GBS).We retrospectively analyzed the clinical data of adult GBS. According to the age, the enrolled subjects were divided into 2 groups, that is, patients ≥60 years (elderly group) and those aged 18 to 59 years (nonelderly group). The clinical characteristics and short-term prognosis of the patients in the 2 groups were compared.In total, 535 patients were enrolled. There were 67 patients fell into the elderly group with a mean age of 69 years old; while 468 patients fell into the nonelderly group with a mean age of 39 years old. We found that the elderly patients had significantly lower incidence of antecedent infections (49.3% vs 66.2%, P < 0.01). The time from onset to admission (5 vs 4 days, P < 0.05) and time from onset to nadir (7 vs 6 days, P < 0.05) were significantly longer in the elderly patients. It was noteworthy that more elderly patients were found with lymphocytopenia (55.4% vs 37.3%, P < 0.01), hyponatremia (25.0% vs 10.2%, P < 0.01), hypoalbuminemia (9.0% vs 2.6%, P < 0.05), and hyperglycemia (34.3% vs 15.2%, P < 0.01). Importantly, the elderly patients had longer duration of hospitalization (17 vs 14 days, P < 0.05), higher incidence of pneumonia (29.9% vs 18.8%, P < 0.05), and poorer short-term prognosis (58.2% vs 42.7%, P < 0.05). In patients with severe GBS, no significant differences were observed in disease severity, treatment modality, incidence of pneumonia, and duration of hospitalization between the 2 groups. However, more patients in the elderly group showed poor short-term prognosis (84.1% vs 63.8%, P < 0.01). Further, old age (≥60 years) (OR = 2.906, 95% CI: 1.174–7.194, P < 0.05) and lower Medical Research Council (MRC) score at nadir (OR = 0.948, 95% CI: 0.927–0.969, P < 0.01) were risk factors for poor short-term prognosis in severe GBS patients.The clinical characteristics and short-term prognosis of elderly patients with GBS are distinct from nonelderly adults. Old age (≥60 years) and lower nadir MRC score serve as predictor for poor short-term prognosis in severe GBS patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The clinical characteristics and short-term prognosis in elderly patients with Guillain–Barré syndrome

Zhang

Wu²,

Shen³

et al. 2017

Medicine

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“…In addition to higher incidence rates of GBS in the elderly, one study found greater severity of the disorder at its peak as well as a higher mortality rate in older individuals compared to younger patients (Peric et al, 2016). In the aforementioned study, the authors striated their patients into young (<60-yearsold), young-old (60-80-years-old), and old-old (>80-years-old).…”

Section: Severitymentioning

confidence: 99%

The Neuroimmunology of Guillain-Barré Syndrome and the Potential Role of an Aging Immune System

Hagen

Ousman

2021

Front. Aging Neurosci.

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Guillain-Barré syndrome (GBS) is a paralyzing autoimmune condition affecting the peripheral nervous system (PNS). Within GBS there are several variants affecting different aspects of the peripheral nerve. In general, there appears to be a role for T cells, macrophages, B cells, and complement in initiating and perpetuating attacks on gangliosides of Schwann cells and axons. Of note, GBS has an increased prevalence and severity with increasing age. In addition, there are alterations in immune cell functioning that may play a role in differences in GBS with age alongside general age-related declines in reparative processes (e.g., delayed de-differentiation of Schwann cells and decline in phagocytic ability of macrophages). The present review will explore the immune response in GBS as well as in animal models of several variants of the disorder. In addition, the potential involvement of an aging immune system in contributing to the increased prevalence and severity of GBS with age will be theorized.

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“…Several studies reported that the GBS incidence rate is enhanced with age, which makes GBS more frequent in the elderly, with 20% of expansion every 10 years of aging [23] . Elderly patients with GBS also present a more severe disease with slow recovery than younger patients [24] , and age was already reported as a predictor of mortality in GBS [25] . The prevalence of GBS in the elderly could be related to the supposed increase in susceptibility to autoimmune diseases in these patients.…”

Section: Gbs Autoimmunity and Agingmentioning

confidence: 99%

Zika Virus Infection in the Elderly: Possible Relationship with Guillain-Barré Syndrome

Savino

Messias²,

Mendes-da-Cruz³

et al. 2016

Gerontology

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The Zika virus (ZIKV) outbreak in French Polynesia, in 2013, and in Brazil, in 2015, was correlated with neurological complications, which comprised, among others, congenital microcephaly and Guillain-Barré syndrome (GBS), which includes a group of acute autoimmune neuropathies generally reported after respiratory or gastrointestinal infectious diseases. Despite being relatively rare, the incidence rate of GBS rises with age, which makes GBS more frequent in the elderly, in whom it is also a more severe disease with slower recovery than in younger patients. Different forms of GBS have been described having diagnostic confirmation of a previous infection with the ZIKV virus. Although we do not have enough evidence that elderly people are a particularly susceptible population to developing GBS following ZIKV infection, this is plausible. We should consider this possibility, particularly taking into account that aging subjects are more susceptible to infections. In this context, a deeper understanding of how the immune system in the elderly functions in relation to ZIKV infection is necessary, as well as an understanding of what kind of alterations of the nervous system such an infection triggers in the elderly, beyond GBS. This will be relevant for better therapeutic interventions and for designing vaccine candidates that can be applied in an aging population, particularly those prone to develop ZIKV-induced autoimmunity.

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Guillain‐Barré syndrome in the elderly

Cited by 18 publications

References 31 publications

The clinical characteristics and short-term prognosis in elderly patients with Guillain–Barré syndrome

The clinical characteristics and short-term prognosis in elderly patients with Guillain–Barré syndrome

The Neuroimmunology of Guillain-Barré Syndrome and the Potential Role of an Aging Immune System

Zika Virus Infection in the Elderly: Possible Relationship with Guillain-Barré Syndrome

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