Dengue, Guillain–Barré Syndrome, and Cerebral Infarction: A Case of Rare Complication

Abstract

Incidence of cerebral infarction after use of intravenous immunoglobulin (IVIG) for treatment of Guillain–Barré syndrome (GBS) is relatively uncommon. Here, we discuss a case of 30-year-old female who was admitted with a complain of thrombocytopenia after infection with dengue virus, who then developed GBS just after a day of discharge. But her woes did not end there, as the GBS progressed rapidly involving her respiratory muscles, leaving her in need of ventilation assistance. Her condition was further deteriorated by development of cerebral infarction that may have been precipitated by the administration of IVIG during the early course of management.How to cite this articlePrateek, Sharma V, Paliwal N, Tak H. Dengue, Guillain–Barré Syndrome, and Cerebral Infarction: A Case of Rare Complications. IJCCM 2019;23(11):533–535.Key messagesIntravenous immunoglobulin in a GBS patient with a hematological abnormality (dengue) should be used with caution. Therapeutic plasma exchange may be considered for management in cases with variable coagulability.

Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil

“…Peripheral nervous system (PNS) involvement in DENV infection occurs in 5% of neurological symptoms, and includes Guillain-Barré syndrome (GBS), which is not commonly observed; hypokalemic quadriparesis or plegia; mononeuritis multiplex; brachial plexitis; diaphragmatic paralysis; and myositis [ 80 , 92 , 93 , 94 , 95 , 96 ]. GBS is an immune-mediated disorder of the PNS that manifests as acute onset of ascending paralysis and sensory symptoms [ 97 ], and is the most common cause of acute flaccid paralysis globally [ 98 ].…”