Association Between Incident Cancer and Guillain-Barré Syndrome Development

Levison, Lotte Sahin; Thomsen, Reimar Wernich; Sindrup, Søren Hein; Andersen, Henning

doi:10.1212/wnl.0000000000200015

Cited by 8 publications

(9 citation statements)

References 36 publications

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“…In accordance with other studies [ 6 ], the most frequent prodromic events were upper respiratory tract infection and gastroenteritis. Guillain–Barré syndrome has also been associated with particular vaccinations [ 25 ], tumor [ 26 ], and autoimmune disease. Other triggers such as trauma and surgery were rarely reported [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Zhai

Guo

Xue

et al. 2022

JCM

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Objectives: Acute motor axonal neuropathy (AMAN) was first reported to be the main subtype of Guillain–Barré syndrome (GBS) in northern China in the 1990s. About 30 years has passed, and it is unknown whether the disease spectrum has changed over time in northern China. We aimed to study the epidemiological, clinical, and electrophysiological features of GBS in northern China in recent years. Methods: We retrospectively analyzed the medical records of GBS patients admitted to the Second Hospital of Hebei Medical University in northern China from 2015 to 2020. Results: A total of 294 patients with GBS were enrolled, with median age 53 years and 60.5% of participants being male, and a high incidence in summer and autumn. AMAN was still the predominant subtype in northern China (40.1%). The AMAN patients had shorter time to nadir, longer hospitalization time, and a more severe HFGS score at discharge than acute inflammatory demyelinating polyneuropathies (AIDP) (p < 0.05). With SPSS multivariable logistic regression analysis, we found the GBS disability score (at admission), dysphagia, and dysautonomia were independent risk factors for GBS patients requiring MV (p < 0.05). In comparison with other regions, the proportion of AMAN in northern China (40.1%) was higher than in eastern (35%) and southern (19%) China. Conclusions: AMAN is still the predominant subtype in northern China after 30 years, but there have been changes over time in the GBS spectrum since the 1990s. There are regional differences in GBS in China.

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Section: Discussionmentioning

confidence: 99%

Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Zhai

Guo

Xue

et al. 2022

JCM

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“…Previous case-reports [5][6][7][8][9][10][11][12][13][14][15][16][17][18] and small cohort studies, 19,20 as well as the recent case-control study, 3 have reported cancers before, concomitantly with, and shortly after the diagnosis of GBS. These diverse approaches complicate the interpretation of the association, in terms of directionality.…”

Section: Discussionmentioning

confidence: 98%

“… 2 A case-control study showed that cancer can be a risk factor for GBS with the strongest associations for hematological cancer. 3 …”

Section: Introductionmentioning

confidence: 99%

“…2 A case-control study showed that cancer can be a risk factor for GBS with the strongest associations for hematological cancer. 3 Cancers can present with paraneoplastic neurological syndromes involving the central or peripheral nervous system, mediated by an autoimmune response. 4 However, whether GBS is a marker of occult cancer remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Girma

Farkas²,

Laugesen³

et al. 2022

CLEP

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Introduction It is unclear whether Guillain–Barré syndrome (GBS) can be a marker of a paraneoplastic syndrome. We examined whether GBS is associated with cancer and whether the prognosis of GBS patients with cancer differs from that of other cancer patients. Materials and Methods We conducted a population-based cohort study of patients diagnosed with GBS between 1978 and 2017 using Danish registry-data. Main outcome measures were cancer incidence and mortality after cancer diagnosis. We calculated absolute risks of a cancer diagnosis, treating death as competing risk, and standardized incidence ratios (SIRs) as measures of relative risk. We matched each GBS cancer patient with up to 10 cancer patients without a GBS diagnosis and examined the six-month survival after cancer diagnosis using Cox regression analysis. Results We identified 7897 patients (58% male, median age 57 years) with GBS. During a median follow-up of 9.5 years, the one-year risk of cancer was 2.7% (95% confidence interval (CI), 2.4–3.1). The SIR was increased throughout follow-up, but most noticeably during the first year after diagnosis (SIR: 3.35, 2.92–3.83). SIRs were particularly elevated for hematologic cancers (SIR: 8.67, 6.49–11.34), smoking-related cancers (SIR: 3.57, 2.81–4.47), and cancers of neurological origin (SIR: 8.60, 5.01–13.77). Lung cancer was the main contributor to the overall excess risk, which persisted after 36 months of follow-up (SIR: 1.17, 1.09–1.25). The mortality rate ratio comparing patients diagnosed with any cancer within one year of their GBS diagnosis and matched GBS-free cancer cohort members was 1.56 (95% CI, 1.27–1.90). Conclusion GBS patients had a three-fold increased risk of cancer diagnosis in the first year of follow-up. The absolute cancer risk was almost 3.0%. A GBS diagnosis was an adverse prognostic marker for survival following cancer diagnosis. Clinicians should consider occult cancer in patients hospitalized with GBS.

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“…To our knowledge, this is the first case that reports a patient with ESCC developing GBS. A large case-control study in Denmark found the most common malignancies associated with GBS were lymphoma, lung, and prostate cancers [ 18 ]. Other malignancies that have been associated are nasal SCC, gastric adenocarcinoma, hepatocellular carcinoma, rectal carcinoma, and myelodysplastic syndrome [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Guillain-Barré-Like Syndrome From Esophageal Squamous Cell Carcinoma

Jordan¹,

Makarova²,

Adashek³

2022

Cureus

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Guillain-Barré-like syndrome (GBS) has been noted in solid tumors such as hepatocellular carcinoma, gastric, breast, and colon cancer and is characterized by an ascending weakness generally with mild paresthesias; however, it has not been noted in esophageal squamous cell carcinoma. A 64-year-old woman with moderately differentiated squamous cell carcinoma of the upper esophagus receiving 5-fluorouracil and cisplatin chemotherapy concurrently with radiation therapy presented for two weeks of progressive lower extremity weakness and numbness. She experienced acute worsening of symptoms after her cisplatin infusion. She underwent a lumbar puncture that revealed findings consistent with GBS and she began treatment with intravenous immunoglobin. She had gradual improvement in her weakness and paresthesias and was discharged to an inpatient rehabilitation facility. This case documents the first noted association between GBS and esophageal squamous cell carcinoma.

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Association Between Incident Cancer and Guillain-Barré Syndrome Development

Cited by 8 publications

References 36 publications

Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Guillain–Barré Syndrome in Northern China: A Retrospective Analysis of 294 Patients from 2015 to 2020

Cancer Diagnosis and Prognosis After Guillain–Barré Syndrome: A Population-Based Cohort Study

Guillain-Barré-Like Syndrome From Esophageal Squamous Cell Carcinoma

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