Campylobacter-associated Guillain–Barré syndrome after orthotopic liver transplantation for hepatitis C cirrhosis: a case report

Abstract

Guillain–Barré syndrome is characterized by acute paralysis and ascending neuropathy due to an inflammatory attack on the myelin of peripheral nerves. About 2/3 of patients with Guillain–Barré syndrome have an infection 1–3 weeks before the onset of the symptoms. Guillain–Barré syndrome has rarely been reported after solid organ transplantation (18 cases with three cases after liver transplantation), and these cases are mostly related to a CMV infection. We describe a 64-year-old male patient who developed Guillain–Barré syndrome related to a Campylobacter fetus enteritis, 70 days post liver transplantation. Although the patient received tacrolimus as immunosuppressant agent and is hepatitis C positive, we can conclude that the Campylobacter infection was probably the primary trigger for the development of Guillain–Barré syndrome. As T-cell response is depressed in our patient and cross-reactive antibodies (anti-ganglioside GM-1) exists after Campylobacter infection, we suppose that a humorally mediated attack is responsible for Guillain–Barré syndrome after solid organ transplantation. A review of the literature is performed.