Abstract

BackgroundGuillain-Barre' syndrome (GBS) is a serious autoimmune disorder in which the immune system attacks healthy nerve cells of the peripheral nervous system causing polyradiculoneuropathy which leads to weakness, numbness, and tingling, and can eventually cause paralysis. Autoimmune conditions like GBS can induce a high level of inflammation resulting in an increase in the C-reactive protein( CRP) production. The aim of this study is to assess the relationship between CRP level and the clinical severity as well as the electrophysiological findings of nerve conduction studies in patients with GBS.MethodsTwenty- four patients (10 males &14 females) with ages ranged from 14 to 50 years and a mean age of 33.46 ±12.25 years who fulfilled the clinical criteria for diagnosing GBS were recruited within the first 2 weeks of onset of illness, in a cross- section study. They underwent general and neurological examination. Nerve conduction studies as well as assessment of serum CRP level were done.ResultsThere was a statistically significant positive correlation between clinical severity assessed by (Hughes disability scale) and serum CRP level in GBS patients. Multivariate logistic regression analysis showed that both gastroenteritis, cranio-bulbar affection, need for mechanical ventilation (MV), disability score >4, and absent motor and sensory responses were significantly associated with high serum CRP level >6mg/dl.ConclusionsThe results of this study support the hypothesis that in GBS patients, gastroenteritis, craniobulbar affection, need for MV, disability score >4, and absent motor and sensory nerve responses were significantly related to high serum CRP level. This reflects the negative impact of the inflammatory response elicited by high CRP level on clinical severity in GBS patients, and so it may be used as a prognostic marker of clinical severity of GBS and this can help in therapeutic decision making.

Highlights

  • Guillain-Barre' syndrome (GBS) is a serious autoimmune disorder in which the immune system attacks healthy nerve cells of the peripheral nervous system causing polyradiculoneuropathy which leads to weakness, numbness, and tingling, and can eventually cause paralysis

  • By multivariate logistic regression analysis, it was found that both preceding infection with gastroenteritis, craniobulbar affection, need for mechanical ventilation (MV), disability score > 4, and absent motor and sensory nerve responses were significantly related to high serum C-reactive protein (CRP) level > 6 mg/dl (Table 6)

  • We found that all patients (100%) had both motor and sensory symptoms, while 54.2% had facial nerve involvement, 16.7% had autonomic symptoms, and 16.7% needed MV

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Summary

Introduction

Guillain-Barre' syndrome (GBS) is a serious autoimmune disorder in which the immune system attacks healthy nerve cells of the peripheral nervous system causing polyradiculoneuropathy which leads to weakness, numbness, and tingling, and can eventually cause paralysis. Guillain-Barré syndrome (GBS) is a severe autoimmune disorder in which the immune system forms autoantibodies against healthy nerve cells of the peripheral nervous system causing polyradiculoneuropathy which in turn causes weakness, numbness, and tingling and can eventually cause paralysis. The cause of this condition is unknown, but it is typically triggered by many. Nerve conduction studies should be repeated for proper diagnosis of GBS subtypes, identification of pathophysiological mechanisms, and assessment of prognosis (Uncini and Kuwabara 2012)

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