Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence
ABSTRACT Background: A treatment-related fluctuation (TRF) in a patient with Guillain-Barré syndrome (GBS) is defined as clinical deterioration within two months of symptom onset following previous stabilization or improvements with treatment. Objective: To investigate the clinical characteristi...
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Thieme Revinter Publicações
2022-02-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005003213&tlng=en |
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| author | Lucas ALESSANDRO Juan Ignacio CASTIGLIONE Patricio BRAND Veronica BRUNO Fabio BARROSO |
| author_facet | Lucas ALESSANDRO Juan Ignacio CASTIGLIONE Patricio BRAND Veronica BRUNO Fabio BARROSO |
| author_sort | Lucas ALESSANDRO |
| collection | DOAJ |
| description | ABSTRACT Background: A treatment-related fluctuation (TRF) in a patient with Guillain-Barré syndrome (GBS) is defined as clinical deterioration within two months of symptom onset following previous stabilization or improvements with treatment. Objective: To investigate the clinical characteristics and factors that could increase the risk of relapse of GBS in patients with and without TRFs. Methods: Retrospective review of medical records of patients (>18 years) with GBS evaluated between January/2006 and July/2019. Demographic and clinical characteristics, ancillary studies, treatment received, and the clinical course of patients with and without TRFs were analyzed. Results: Overall, 124 cases of GBS were included; seven (5.6%) presented TRFs. GBS-TRF cases were triggered more frequently by infectious mononucleosis (28.57 vs. 8.55%; p=0.01). GBS-TRF were initially treated with plasmapheresis more frequently than those without TRF (14.29 vs. 1.70%; p=0.0349). Combined treatment (71.43 vs. 4.27%; p<0.001) and corticosteroids (42.86 vs. 1.71%; p<0.001) were more commonly used in the GBS-TRF group. GBS-TRF patients presented a higher median initial disability score (4 vs. 2; p=0.01). Conclusions: Patients with GBS triggered by infectious mononucleosis and a high degree of initial disability have higher chances of developing TRFs. Although patients with TRF were treated with plasmapheresis more often, the total number was too low to suggest a link between plasma exchange and TRF. |
| format | Article |
| id | doaj-art-13cfa10873fe4a6ba7c6064df9df210e |
| institution | DOAJ |
| issn | 1678-4227 |
| language | English |
| publishDate | 2022-02-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-13cfa10873fe4a6ba7c6064df9df210e2025-08-20T03:17:02ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272022-02-0110.1590/0004-282x-anp-2021-0226Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrenceLucas ALESSANDROhttps://orcid.org/0000-0002-8597-8213Juan Ignacio CASTIGLIONEhttps://orcid.org/0000-0002-2689-5805Patricio BRANDhttps://orcid.org/0000-0001-5117-245XVeronica BRUNOhttps://orcid.org/0000-0003-2378-6328Fabio BARROSOhttps://orcid.org/0000-0002-3647-1803ABSTRACT Background: A treatment-related fluctuation (TRF) in a patient with Guillain-Barré syndrome (GBS) is defined as clinical deterioration within two months of symptom onset following previous stabilization or improvements with treatment. Objective: To investigate the clinical characteristics and factors that could increase the risk of relapse of GBS in patients with and without TRFs. Methods: Retrospective review of medical records of patients (>18 years) with GBS evaluated between January/2006 and July/2019. Demographic and clinical characteristics, ancillary studies, treatment received, and the clinical course of patients with and without TRFs were analyzed. Results: Overall, 124 cases of GBS were included; seven (5.6%) presented TRFs. GBS-TRF cases were triggered more frequently by infectious mononucleosis (28.57 vs. 8.55%; p=0.01). GBS-TRF were initially treated with plasmapheresis more frequently than those without TRF (14.29 vs. 1.70%; p=0.0349). Combined treatment (71.43 vs. 4.27%; p<0.001) and corticosteroids (42.86 vs. 1.71%; p<0.001) were more commonly used in the GBS-TRF group. GBS-TRF patients presented a higher median initial disability score (4 vs. 2; p=0.01). Conclusions: Patients with GBS triggered by infectious mononucleosis and a high degree of initial disability have higher chances of developing TRFs. Although patients with TRF were treated with plasmapheresis more often, the total number was too low to suggest a link between plasma exchange and TRF.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005003213&tlng=enCytomegalovirusHerpesvirus 4, HumanGuillain-Barré SyndromeInfectious Mononucleosis |
| spellingShingle | Lucas ALESSANDRO Juan Ignacio CASTIGLIONE Patricio BRAND Veronica BRUNO Fabio BARROSO Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence Arquivos de Neuro-Psiquiatria Cytomegalovirus Herpesvirus 4, Human Guillain-Barré Syndrome Infectious Mononucleosis |
| title | Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence |
| title_full | Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence |
| title_fullStr | Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence |
| title_full_unstemmed | Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence |
| title_short | Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence |
| title_sort | treatment related fluctuations in guillain barre syndrome clinical features and predictors of recurrence |
| topic | Cytomegalovirus Herpesvirus 4, Human Guillain-Barré Syndrome Infectious Mononucleosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2022005003213&tlng=en |
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