Abstract
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that can cause total motor paralysis in severe cases. Reports of hypercalcaemia in patients with GBS are rare. Plasmapheresis, an extracorporeal blood purification procedure for the removal of large molecular weight substances, is a well-established therapy for ventilated GBS patients. Although it has been observed in a few reported cases, theoretically, hypercalcaemia is not described as a plasmapheresis-related problem unless there is an underlying cause. We present a rare case of an 8-year-old child presenting with headache, diplopia, and squint, followed by disturbed conscious levels and paralysis. He was treated with both intravenous immunoglobulin and plasmapheresis, with a favourable outcome. We made a laboratory observation of hypercalcaemia which was associated with the plasmapheresis therapy without any related underlying cause. This raises the need for similar observations and the gathering of other possible acceptable explanations.
Highlights
Case ReportAn urgent computerised tomography (CT) scan of the brain followed by a magnetic resonance imaging (MRI) scan were both completely normal
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that can cause total motor paralysis in severe cases
An urgent computerised tomography (CT) scan of the brain followed by a magnetic resonance imaging (MRI) scan were both completely normal
Summary
An urgent computerised tomography (CT) scan of the brain followed by a magnetic resonance imaging (MRI) scan were both completely normal He was labelled as pseudotumor cerebri and was started on intravenous (IV) methylprednisolone and mannitol. A CaCl2 infusion was held to assess the response following the session Both the total serum Ca and the albumin-adjusted Ca were high (3.33 and 3.38 mmol/L, respectively). A quick revision for the infused fluid and hydration status, and urine output before and after the procedure was unremarkable as reflected by the following laboratory results: albumin 38 g/L, PO4 1.4 mmol/L, Na 139, K 3.4, Cl 102, bicarbonate 26, creatinine 19, urea 6.5, haematocrit 0.32 L/L, anion gap 11, pH 7.37, and alkaline phosphatase was slightly high (483 u/L). Other specific investigations related to hypercalcaemia included normal 25-hydroxy
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