High proportion of Guillain-Barré syndrome associated with chikungunya in Northeast Brazil

Matos, Aline de Moura Brasil; Carvalho, Fernanda; Malta, D. L.; Rodrigues, Cleonísio Leite; Félix, Alvina Clara; Pannuti, Cláudio Sérgio; Lima, Amanda Dias da Rocha; Espósito, Danilo Lucas Alves; Santos, Leonilda Maria Barbosa dos; Glehn, Felipe von; Colares, Jeová Keny Baima; Fonseca, Benedito Antônio Lopes da; Oliveira, Augusto César Penalva de; Romano, Camila Malta

doi:10.1212/nxi.0000000000000833

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…Unlike our findings, a case-control study conducted in Bahia State, Northeast Brazil, indicated that GBS was strongly associated with ZIKV, with a 6% mortality rate in this study group, suggesting that prior ZIKV infection may result in severe neurological complications 27 . We observed a high proportion of patients with prior GBS-associated CHIKV infection, corroborating the findings of a study conducted in another Northeastern Brazilian state 28 . Thus, the presence of GBS does not necessarily indicate an association with ZIKV.…”

Section: Discussionsupporting

confidence: 90%

Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil

Lima

Montarroyos

Magalhães

et al. 2020

Rev. Inst. Med. trop. S. Paulo

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Section: Discussionsupporting

confidence: 90%

Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil

Lima

Montarroyos

Magalhães

et al. 2020

Rev. Inst. Med. trop. S. Paulo

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“…This is similar to the studies from Brazil which have shown that along with ZIKA, CHIK is also an important risk factor for GBS. [ 2 7 14 ]…”

Section: Discussionmentioning

confidence: 99%

Guillain-barre syndrome and antibodies to arboviruses (Dengue, Chikungunya and Japanese Encephalitis): A prospective study of 95 patients form a tertiary care centre in Southern India

Amalnath

Pari

Dhodapkar

2022

Ann Indian Acad Neurol

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Objective: The aim of this study was to detect the presence of IgM antibodies against dengue (DEN), chikungunya (CHIK) and Japanese encephalitis (JE) in the serum and CSF of patients with Guillaine-Barre syndrome (GBS). Methods: GBS patients (>12 years of age) were included after informed consent. Data on history, clinical manifestations, treatment details, and outcome were collected. Serum and CSF were tested for IgM antibodies against DEN, CHIK, and JE. Results: From April 2018 to December 2019, 95 patients were included in this study. Anti-arboviral IgM antibodies were detected in 30 patients (31.5%) (CSF 11, serum 13, both CSF and serum 6). Serum IgM antibody was present in 19 patients (JE 8, DEN 5, CHIK 2, more than 1 virus 4). Of the 66 patients who underwent CSF studies, antibodies were present in 17 (CHIK 14, DEN 1, more than 1 virus 2). Antibody positivity did not affect the outcome of GBS. Conclusion: One-third of the GBS patients had evidence of recent infection by arboviruses. This suggests that DEN, CHIK, and JE could be the inciting event for GBS in endemic regions.

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“…Other arthropod-borne viruses (arboviruses) transmitted by the same mosquito, including dengue virus (DENV) and chikungunya virus (CHIKV), have also been associated with GBS, although evidence of an association is limited in comparison with ZIKV. 6,[9][10][11][12][13][14][15][16][17][18] Most studies on DENV and GBS are limited to case series, 10,[18][19][20][21][22] although two surveillances studies 17,18 showed a temporal association between the incidence of GBS and DENV, and one case-control study provided evidence of an association between GBS and DENV. 23 Several studies have linked clusters of GBS cases with outbreaks of CHIKV, 15,[24][25][26] and a case-control study 9 demonstrated that CHIKV is a risk factor for GBS.…”

Section: Introductionmentioning

confidence: 99%

“…6,[9][10][11][12][13][14][15][16][17][18] Most studies on DENV and GBS are limited to case series, 10,[18][19][20][21][22] although two surveillances studies 17,18 showed a temporal association between the incidence of GBS and DENV, and one case-control study provided evidence of an association between GBS and DENV. 23 Several studies have linked clusters of GBS cases with outbreaks of CHIKV, 15,[24][25][26] and a case-control study 9 demonstrated that CHIKV is a risk factor for GBS. Arboviruses have been increasingly recognized as a global health threat, as their geographic distribution has spread dramatically over the past decades.…”

Section: Introductionmentioning

confidence: 99%

Antecedent infections in Guillain‐Barré syndrome in endemic areas of arbovirus transmission: A multinational case‐control study

Leonhard

Tan

Eijk

et al. 2021

J Peripheral Nervous Sys

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Half of the world's population is at risk of arthropod-borne virus (arbovirus) infections. Several arbovirus infections have been associated with Guillain-Barré syndrome (GBS). We investigated whether arboviruses are driving GBS beyond epidemic phases of transmission and studied the antibody response to glycolipids. The protocol of the International Guillain-Barré syndrome Outcome Study (IGOS), an observational prospective cohort study, was adapted to a case-control design. Serum samples were tested for a recent infection with Zika virus (ZIKV), dengue virus (DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), Campylobacter jejuni, and Mycoplasma pneumoniae, and for antibodies to glycolipids. Forty-nine patients were included from Brazil (63%), Argentina (14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%) patients: C jejuni (n = 15, 31%), M pneumoniae (n = 5, 10%), CHIKV (n = 2, 4%), EBV (n = 1, 2%), C jejuni and M pneumoniae (n = 2, 4%), CMV and DENV (n = 1, 2%), and C jejuni and DENV (n = 1, 2%). In 22 patients, 35 paired controls were collected.Odds ratio for recent infections did not significantly differ between cases and controls. No typical anti-ganglioside antibody binding was associated with recent arbovirus infection. We conclude that arbovirus infections occur in GBS patients outside of epidemic viral transmission, although not significantly more than in controls. Broad infection and anti-ganglioside antibody serology are important to establish the most likely pathogenic trigger in GBS patients. Larger studies are necessary to determine the association between arboviruses and GBS.

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High proportion of Guillain-Barré syndrome associated with chikungunya in Northeast Brazil

Cited by 7 publications

References 8 publications

Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil

Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil

Guillain-barre syndrome and antibodies to arboviruses (Dengue, Chikungunya and Japanese Encephalitis): A prospective study of 95 patients form a tertiary care centre in Southern India

Antecedent infections in Guillain‐Barré syndrome in endemic areas of arbovirus transmission: A multinational case‐control study

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