Guillain–Barre syndrome and pregnancy: A case report

Abstract

Objectives Guillain–Barre syndrome (GBS) is an acute inflammatory autoimmune neuritis. It is often preceded by an infection, surgery, immunization, lymphoma, or exposure to toxins. Common clinical manifestations include progressive weakness, loss of sensation, and loss of deep tendon reflexes. Weakness of respiratory muscles and autonomic dysfunction may occur. GBS is a rare condition, and it is even rarer during pregnancy with incidences of 1.2–1.9 cases per 100,000 annually [2] . Case report We report a case of a 27-year-old nulliparous woman at 38 weeks gestation who consulted for paresthesia of limbs. She firstly diagnosed as hypocalcemia. Then she developed progressive paresis with respiratory failure. The medical history revealed the occurrence of flue two weeks before. The diagnosis of GBS was confirmed by the albuminocytological dissociation in the cerebrospinal fluid and Electroneuromyography. A fetal extraction was indicated then the patient was transferred to reanimation unit for ventilator support and received intravenous immunoglobulin. The patient was extubated after 10 days and the newborn baby was in a good health. Conclusion GBS can appear at any stage of pregnancy [1] . However it seems to be more frequent within the second and third trimester and moreover within the first month of post-partum [3] . This syndrome does not increase the risk of miscarriage or fetal death neither affects the fetal development. No study demonstrated the involvement of GBS in abortion [1] . The respiratory failure is the biggest challenge in GBS when it occurs in a pregnant woman and the safe use of immunoglobulin within pregnancy had transformed the prognosis. GBS is rare during pregnancy and its symptoms can be confused with normal pregnancy symptoms. The diagnosis is usually made on clinical grounds supported by CSF examination, serology and nerve studies. Management of GBS is by a multidisciplinary team including gynecologist, neurologist and resuscitator.