Novel association of GBS: Post-hepatitis demyelinating motor neuropathy
Journal Title: International Journal of Medical and Health Sciences - Year 2015, Vol 4, Issue 3
Abstract
Introduction: Guillain-Barré syndrome (GBS) is a neurological emergency that warrants prompt diagnosis and treatment. Occasionally, the clinical, laboratory and electrophysiological features are neither typical nor diagnostic. It requires a high index of suspicion and clinical judgement for early diagnosis and commencement of treatment in such scenarios. Some pathogens are potential triggers of this serious neurological disease, including: Campylobacter jejuni, Mycoplasma pneumoniae and Cytomegalovirus. Although uncommon, hepatotrophic viruses (Hepatitis A, B, C and E virus) are increasingly recognized to be triggering microbes of GBS. The objective of this report is to highlight the association of hepatotrophic viruses with GuillainBarré syndrome. We describe a rare case of GBS following acute hepatitis. Case report: A 24 years old lady presented to us with GBS triggered by Hepatitis A virus leading to severe demyelinating type peripheral neuropathy. The patient initially developed symptoms of hepatitis followed by rapidly progressive ascending flaccid quadriparesis with facial diplegia. During this period, she had her hepatitis A IgM recorded twice as positive. She underwent 5 sessions of plasma exchange (250ml/kg) with good clinical response and uneventful recovery over a period of 6 months with no sequlae. Conclusions: While GBS has been linked to a number of viral etiologies, association between hepatotrophic viruses and GBS is a rare but nonetheless important entity. Physicians should therefore carefully examine their patients with limb weakness in recovery phase of hepatitis particularly for signs of peripheral neuropathy to timely recognize and treat a potentially recoverable but dreadfully disabling disease.
Authors and Affiliations
Ali Zohair Nomani, Uzma Jamil, Zakir Jan, Haris Majid Rajput, Mansoor Iqbal, Hanin Bashar Mustafa Tanich, Rao Sohail Yasin Khan, Muhammad Irshad, Mazhar Badshah
Keywords
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