Guillain-Barre syndrome as a paraneoplastic syndrome in a 17-year- old boy

Abstract

Guillain-Barre syndrome (GBS) is an acute inflammatory polyneuropathy, characterised by progressive, symmetrical muscle weakness and sensory disorder due to autoimmunologic myelin nerve sheats and/or peripheral nerves axonal damage. The course of the disease in children is usually milder than in adults. The most common variant of GBS is acute inflammatory demyelinating polyneuropathy (AIDP). GBS is a rare disorder with morbidity rate of 0,5-1,5/100 000/ year, more often seen in males. The course of disease in children is usually milder than in adults. Early diagnosis and proper treatment enables complete recovery in 80% of cases, while approximately 10% of patients suffer from symptoms recurrence, mainly after infection. Almost 2/3 of GBS cases are preceded by upper respiratory or gastrointestinal infection. The emergence of antibodies in various mechanisms, which cross react with nerve sheats or axon antigens (through a phenomenon known as molecular mimicry), leads to development of the syndrome. Known triggers inducing GBS include viral and bacterial infections, injuries, surgery, bone marrow transplantation and rarely childhood vaccinations. In still rarer cases, GBS may develop in the course of paraneoplastic syndrome (PNS), and be the first symptom of an underlying neoplastic process.