Guillain–Barre syndrome

格林 - 巴利综合征
  • 文章类型: Journal Article
    已发现格林-巴利综合征(GBS)与疫苗接种有一些有趣的关联。本文主要探讨COVID-19疫苗接种与GBS之间的不同关联。
    电子数据库,如PubMed,谷歌学者,科克伦,和Embase使用MESH术语检索了截至2023年8月1日发布的病例报告,其中记录了70例病例报告,涉及来自23个不同国家的103人.
    病例报告来自13至87岁的广泛个体,平均年龄为53±20四分位龄,男性占优势。接种疫苗和症状发作之间的平均时间为13.08±2.14天。突出的临床特征包括背痛,面部瘫痪,弱点,和感觉异常,而主要的诊断研究是脑脊液(CSF)分析和电磁研究。主要诊断线索是脑脊液中白蛋白细胞学解离,同时抗神经节苷脂抗体或SARS-CoV-2阴性。可用的治疗选择包括静脉注射免疫球蛋白和血浆置换。患有糖尿病等合并症的患者,高血压,血脂异常,永久性心房颤动,甲状腺功能减退,桥本甲状腺炎,慢性阻塞性肺疾病,哮喘,骨质疏松,偏头痛,类风湿性关节炎,骨关节炎,溃疡性结肠炎,乳糜泻,癫痫发作,双相情感障碍,子宫内膜异位症,多发性硬化症,贝尔麻痹,鳞状细胞癌,前列腺癌被纳入我们的研究.
    总的来说,这篇综述评估了COVID-19疫苗接种与GBS之间的创新性和临床相关关联.了解COVID-19疫苗接种的这种罕见的潜在副作用对于及时诊断和适当治疗至关重要。重要的是,GBS不应被视为疫苗接种的禁忌症。这强调了正在进行的研究以提高COVID-19疫苗接种工作的安全性和有效性的重要性。
    UNASSIGNED: Guillain-Barre syndrome (GBS) has been found to have some interesting association with vaccinations. This paper mainly focuses on exploring different associations between COVID-19 vaccination and GBS.
    UNASSIGNED: Electronic databases such as PubMed, Google Scholar, Cochrane, and Embase were searched using MESH terms for case reports published till 1 August 2023 from which 70 case reports were documented involving 103 individuals from 23 different countries.
    UNASSIGNED: The case reports were from a wide range of individuals aged from 13 to 87 years with an average age of 53±20 interquartile range years along with male predominance. The average time between receiving the vaccine and the onset of symptoms was 13.08±2.14 days. Prominent clinical features included back pain, facial diplegia, weakness, and paraesthesia whereas the main diagnostic studies were cerebrospinal fluid (CSF) analysis and electromagnetic studies. The principal diagnostic clue was albumin-cytological dissociation in CSF while being negative for anti-ganglioside antibodies or SARS-CoV-2. Available treatment options consisted of intravenous immunoglobulin and Plasmapheresis. Patients with comorbidities such as diabetes mellitus, hypertension, dyslipidemia, permanent atrial fibrillation, hypothyroidism, Hashimoto\'s thyroiditis, Chronic Obstructive Pulmonary Disease, asthma, osteoporosis, migraine, rheumatoid arthritis, osteoarthritis, ulcerative colitis, coeliac disease, seizures, bipolar disorder, endometriosis, multiple sclerosis, bell\'s palsy, squamous cell carcinoma, prostate cancer were included in our study.
    UNASSIGNED: Overall, this review evaluated innovative and clinically relevant associations between COVID-19 vaccination and GBS. Understanding of this uncommon potential side effect of COVID-19 vaccination is crucial for prompt diagnosis and appropriate treatment. Importantly, GBS should not be considered a contraindication to vaccination. This underscores the importance of ongoing research to enhance the safety and efficacy of COVID-19 vaccination efforts.
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  • 文章类型: Journal Article
    在格林-巴利综合征(GBS)的病理生理学中,炎症和免疫被认为起着关键作用。中性粒细胞-淋巴细胞比率(NLR),单核细胞-淋巴细胞比率(MLR),和血小板-淋巴细胞比率(PLR)最近被认为是炎症或免疫的潜在标志物。本研究旨在调查NLR是否,MLR,PLR与儿童GBS特征相关。我们还评估了COVID-19大流行对伊朗GBS特征的影响。
    在这项回顾性横断面研究中,我们回顾了2017年3月至2022年3月在德黑兰医科大学附属儿童医疗中心医院诊断为GBS的所有150名儿童的记录.TUMS研究伦理委员会批准了这项研究(伦理代码:IR。TUMS。CHMC.REC.1399.125).患者数据,包括性别,年龄,临床症状,实验室发现,收集和分析电诊断研究结果。
    这项研究涉及150名儿童,包括93个男孩和57个女孩,平均年龄为7.53±3.75岁。分析表明,住院天数随着NLR的增加而增加(p=0.025)。此外,电诊断研究模式异常的患者重症监护病房(ICU)入院的风险较高(p:0.027),尽管根据二元逻辑回归,入院时呼吸衰竭是增加ICU入院风险的唯一显著因素(p=0.035).该研究还发现,大流行已导致从急性炎症性脱髓鞘性多发性神经病转变为急性运动性轴索神经病,这是我们患者中最常见的EMG-NCV模式(p<0.001)。
    我们发现,较高的NLR与较长的住院时间有关,并可能区分严重和轻度的GBS病例。我们还表明,COVID-19大流行改变了我们患者最常见的肌电图和神经传导速度(EMG-NCV)模式。
    UNASSIGNED: In the pathophysiology of Guillain-Barre syndrome (GBS), inflammation and immunity are believed to play a key role. The neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) have been recently identified as potential markers of inflammation or immunity. This study aimed to investigate whether NLR, MLR, and PLR are associated with GBS characteristics in children. We also assessed the impact of the COVID-19 pandemic on the characteristics of GBS in Iran.
    UNASSIGNED: In this retrospective cross-sectional study, we reviewed the records of all 150 children diagnosed with GBS in the Children\'s Medical Center hospital affiliated with Tehran University of Medical Sciences (TUMS) from March 2017 until March 2022. The TUMS research ethics committee approved the study (Ethics code: IR.TUMS.CHMC.REC.1399.125). Patients\' data including gender, age, clinical symptoms, laboratory findings, and electrodiagnostic study results were collected and analyzed.
    UNASSIGNED: This study involved 150 children, comprising 93 boys and 57 girls, with an average age of 7.53 ± 3.75 years. The analysis demonstrated that the number of hospitalization days increased with an increase in NLR (p = 0.025). Moreover, patients with abnormal electrodiagnostic study patterns had a higher risk of intensive care unit (ICU) admission (p: 0.027), although according to binary logistic regression, respiratory failure at admission time was the only significant factor increasing the risk of ICU admission (p = 0.035). The study also found that the pandemic has resulted in a shift from acute inflammatory demyelinating polyneuropathy to acute motor axonal neuropathy as the most common EMG-NCV pattern in our patients (p < 0.001).
    UNASSIGNED: We found that higher NLR was associated with a longer hospitalization duration and could potentially distinguish between severe and mild cases of GBS. We have also shown that the COVID-19 pandemic has changed our patients\' most frequent electromyography and nerve conduction velocity (EMG-NCV) patterns.
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  • 文章类型: Journal Article
    自1998年以来,肠道病毒71型(EV71)的C4亚基因型已被确定为在中国大陆流行的最主要的亚基因型。由于实验数据不足,1998年之前EV71的流通情况尚不完善。到目前为止,中国大陆尚未报道EV71的C1亚型。根据中国大陆的法新社监视系统,这项研究对1985-1999年的AFP病例进行了回顾性研究:发现了一株EV-A71C1亚型。据我们所知,该菌株(SD92-41)是中国大陆报道的第一个C1亚基因型。这项研究表明,C1基因亚型也出现在中国大陆,但目前尚不清楚是进口还是本地流行菌株。从回顾性研究中了解到足够的信息,将确定SD92-41菌株的来源,并且在1998年之前EV-A71在中国大陆的流行将更加清晰。
    The C4 sub-genotype of Enterovirus 71 (EV71) has been identified as the most dominant sub-genotype circulating in the Chinese mainland since 1998. The circulation situation of EV71 before 1998 is not well established due to insufficient experimental data. The C1 subgenotype of EV71 has not yet been reported in the Chinese mainland by now. Based on the AFP surveillance system of the mainland of China, this study conducted a retrospective study of AFP cases for 1985-1999: a strain of EV-A71 C1 subgenotype was found. To our knowledge, this strain (SD92-41) is the first C1 sub-genotype reported in the Chinese mainland. This study demonstrates that the C1 gene subtype also appeared in the Chinese mainland, but it is unknown whether it is an imported or a local epidemic strain. With sufficient information known from retrospective studies, the source of the SD92-41 strain will be identified and the prevalence of EV-A71 in the Chinese mainland before 1998 will be clearer.
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  • 文章类型: Case Reports
    格林-巴利综合征(GBS)是一组影响周围神经的免疫介导性疾病。使用标准剂量的血浆置换或静脉免疫球蛋白治疗的患者中约有40%在治疗后的前4周内没有改善。越来越多地寻求传统医学方法的附加治疗,如瑜伽疗法和阿育吠陀疗法,用于慢性神经系统疾病患者的康复。当前的案例研究报告了辅助瑜伽和阿育吠陀治疗在治疗GBS残留症状中的临床实用性。
    Guillain-Barre syndrome (GBS) is a heterogenous group of immune-mediated conditions affecting peripheral nerves. About 40% of patients treated with standard dosage of plasma exchange or intravenous immunoglobulins do not improve in the first 4 weeks following treatment. Add-on treatment from traditional medical approaches such as Yoga therapy and Ayurveda are increasingly being sought for rehabilitation of patients with chronic neurological disorders. The current case study reports the clinical utility of adjunct Yoga and Ayurveda treatment in the treatment of residual symptoms of GBS.
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  • 文章类型: Journal Article
    未经批准:研究COVID-19大流行对频率的影响,儿童格林-巴利综合征(GBS)的临床/电生理特征和治疗结果。
    未经证实:GBS是小儿急性弛缓性麻痹的最常见原因。文献中尚不清楚COVID-19大流行对小儿GBS的影响。
    未经授权:我们进行了一项综合调查,多中心,队列研究涉及GBS联盟27个中心中的12个,在两个时期:COVID-19之前(2019年3月至8月)和COVID-19期间(2020年3月至8月)。纳入符合国家神经疾病研究所和卒中GBS/变异标准的≤12岁儿童。有关临床/实验室参数的详细信息,治疗和结果(出院时改良的Rankin量表(mRS),分析出院和3个月时的GBS残疾评分)。
    未经评估:我们在2019年招收了33名儿童,在2020年招收了10名儿童。2020年的儿童年龄较大(中位数为10.4[四分位距6.75-11.25]岁,而5(2.5-8.4)岁;P=0.022),并且有更多的感觉症状(50%对18.2%;P=0.043)。与2019年相比,2020年组中出院时的mRS相对较好(中位数为1(1-3.5)对3(2-4);P=0.042)和3个月时的GBS残疾评分(中位数为0(0-0.75)对2(0-3);P=0.009)。多因素分析显示肠受累(P=0.000)和通气支持(P=0.001)是残疾的独立预测因子。2020年没有儿童之前/同时感染SARS-CoV2。
    未经证实:COVID-19大流行导致医院就诊的儿科GBS明显下降。先前的疾病,与大流行前时期相比,GBS的临床和电生理特征基本保持不变.
    UNASSIGNED: To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barré syndrome (GBS).
    UNASSIGNED: GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature.
    UNASSIGNED: We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children ≤12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed.
    UNASSIGNED: We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75-11.25] years versus 5 (2.5-8.4) years; P = 0.022) and had more sensory symptoms (50% versus 18.2%; P = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1-3.5) versus 3 (2-4); P = 0.042) and GBS disability score at 3 months (median 0 (0-0.75) versus 2 (0-3); P = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement (P = 0.000) and ventilatory support (P = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection.
    UNASSIGNED: The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.
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  • 文章类型: Journal Article
    背景:格林-巴利综合征(GBS)是一种炎症性多发性神经根神经病,其特征是迅速发展的无力和反射,在4周内达到最低点。关于沙特阿拉伯GBS特征的数据有限。本研究旨在描述临床,电生理学,以及多中心GBS患者队列的实验室特征和结果。
    方法:这是一项全国性的多中心回顾性研究。患有GBS的患者,通过布莱顿标准确定,包括2015年1月至2019年12月。收集的数据包括人口统计,临床特征,脑脊液剖面,报告的电生理模式,治疗,和结果。使用卡方比较报告的GBS亚型,费希尔的精确,或者Mann-WhitneyU测试,视情况而定。
    结果:共包括156例GBS患者(男性,61.5%),年龄中位数为38岁(四分位数间距,26.25-53.5)年。最常见的先前疾病是上呼吸道感染(39.1%)和腹泻(27.8%)。除两名患者(98.7%)外,所有患者均有虚弱,64.1%有感觉症状,43.1%有面部双瘫,33.8%有口咽无力,12.4%有眼肌麻痹,26.3%需要机械通气。在69.1%的患者中观察到细胞白蛋白解离。96.8%的患者接受了GBS特异性治疗,其中88.1%有静脉注射免疫球蛋白,11.9%有血浆置换。大约一半的患者在出院后9个月内能够独立行走,三分之一的人此后恢复了独立行走的能力。一名患者的死亡是由败血症引起的。急性炎性脱髓鞘性多发性神经根神经病是最常见的GBS亚型(37.7%),其次是急性运动性轴索神经病(29.5%),和急性运动感觉轴索神经病(19.2%)。
    结论:沙特阿拉伯阿拉伯人口中GBS的临床和实验室特征以及结果与国际队列相似。总体预后良好。
    BACKGROUND: Guillain-Barre syndrome (GBS) is an inflammatory polyradiculoneuropathy characterized by rapidly evolving weakness and areflexia, reaching nadir within 4 weeks. Data on the characteristic of GBS in Saudi Arabia are limited. This study aimed to describe the clinical, electrophysiological, and laboratory characteristics and outcome of a multicenter cohort of patients with GBS.
    METHODS: This is a retrospective multicenter nationwide study. Patients who had GBS, identified through Brighton Criteria, between January 2015 and December 2019 were included. Data collected included demographics, clinical features, cerebrospinal fluid profile, reported electrophysiological patterns, treatment, and outcome. Reported GBS subtypes were compared using chi-square, Fisher\'s exact, or Mann-Whitney U tests, as appropriate.
    RESULTS: A total of 156 patients with GBS were included (men, 61.5%), with a median age of 38 (interquartile range, 26.25-53.5) years. The most commonly reported antecedent illnesses were upper respiratory tract infection (39.1%) and diarrhea (27.8%). All but two patients (98.7%) had weakness, 64.1% had sensory symptoms, 43.1% had facial diplegia, 33.8% had oropharyngeal weakness, 12.4% had ophthalmoplegia, and 26.3% needed mechanical ventilation. Cytoalbuminological dissociation was observed in 69.1% of the patients. GBS-specific therapy was administered in 96.8% of the patients, of whom 88.1% had intravenous immunoglobulin, and 11.9% had plasmapheresis. Approximately half of the patients were able to walk independently within 9 months after discharge, and a third regained the ability to walk independently thereafter. Death of one patient was caused by septicemia. Acute inflammatory demyelinating polyradiculoneuropathy was the most commonly reported GBS subtype (37.7%), followed by acute motor axonal neuropathy (29.5%), and acute motor-sensory axonal neuropathy (19.2%).
    CONCLUSIONS: The clinical and laboratory characteristics and outcome of GBS in the Arab population of Saudi Arabia are similar to the international cohorts. The overall prognosis is favorable.
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  • 文章类型: Journal Article
    BACKGROUND: The objective of this article was to study the presence of antibodies against Zika virus (ZIKV), Campylobacter jejuni, and gangliosides in patients with Guillain-Barre syndrome (GBS).
    METHODS: Ninety consecutive patients (age more than 12 years) with GBS admitted to a tertiary care center in southern India were included in this study. Data on clinical manifestations, nerve conduction studies, and response to therapy were collected. The following tests were done in stored serum samples - anti-ZIKV (IgM) antibodies, anti-C. jejuni (IgG) antibodies, and anti-ganglioside antibodies (IgG). Those samples which were positive to anti-Zika antibodies were tested for conventional polymerase chain reaction for ZIKV and IgM antibodies against dengue, and Japanese encephalitis virus.
    RESULTS: Of the 90 patients, 3 died and 8 had persistent weakness. Acute inflammatory demyelinating polyradiculoneuropathy was the most common type of GBS (56.7%). Anti-ganglioside antibodies were present in 62.2% patients with GT1b being the most common. Anti-C. jejuni antibodies were present in 46.6%. Anti-Zika antibodies (IgM) were present in 14 patients (15.5%). Four of these patients also had anti-dengue antibody (IgM) positivity.
    CONCLUSIONS: This is one of the largest studies on GBS from India and the first one to report on the presence of Zika virus antibodies from this geographical area. Our study had a high prevalence of anti-C. jejuni and anti-ganglioside antibodies. Evidence of recent ZIKV infection, as evidenced by anti-IgM antibodies, was present in 14 patients, with 4 of them being tested positive for anti-dengue IgM antibody. Whether this represents cross-reaction with dengue or prior/co-infection with dengue virus could not be addressed in this study.
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