Guillain-Barre syndrome associated with peginterferon alfa-2a for chronic hepatitis C: A case report

Abstract

The recommended therapy for chronic hepatitis C (CHC) infection is the combination of a Pegylated interferon and Ribavirin. Almost all such patients on combination therapy experience one or more adverse events during the course of treatment. Significant neurological side effects are rare. A few cases of Bell's Palsy, chronic in flammatory demyelinating polyneuropathy and even one case of acute demyelinating polyneuropathy with atypical features for GuillainBarre syndrome (GBS) associated with Interferon therapy have been reported but no report of GBS with typical features has been published. We present a case report of typical GBS associated with Peginterferon alfa2a and Ribavirin used for treatment of CHC infection.

Guillain–Barré syndrome following acute co‐super‐infection of hepatitis E virus and cytomegalovirus in a chronic hepatitis B virus carrier

“…Infection of hepatotropic viruses, especially HEV, or inoculation of hepatitis vaccines can lead to GBS. [Lin et al, ; Chroni et al, ; Khamaisi et al, ; Niazi et al, ; Kumar et al, ; Yimam et al, ; Menon et al, ; Woolson et al, ; Bazerbachi et al, ; Dalton et al, ]. In the two case‐controlled studies of GBS of all etiologies, 100 patients in Bangladesh and 201 patients in Netherlands were involved, and acute HEV infection was associated with GBS in 11% and 5% of the patients, respectively [van den Berg et al, ].…”

“…Although the pathological organism is not often identified, the usual infectious agents associated with subsequent GBS include campylobacter jejuni, Epstein-Barr virus (EBV), cytomegalovirus (CMV), and mycoplasma pneumonia [Pithadia and Kakadia, 2010;Willison et al, 2016]. Infections especially acute infections of hepatotropic virus, that is, hepatitis A virus (HAV), HBV, hepatitis C virus (HCV), delta virus, and hepatitis E virus (HEV), can also cause GBS in few cases [Lin et al, 1989;Chroni et al, 2003;Niazi et al, 2010;Pithadia and Kakadia, 2010;Kappus and Sterling, 2013;Yimam et al, 2013;Menon et al, 2014;Bazerbachi et al, 2016;Dalton et al, 2016;Sarin et al, 2016;Willison et al, 2016]. So, when the patients with hepatotropic virus infection, especially with chronic HBV infection, are complicated with GBS, co-infection, or super-infection with other pathogens should be excluded.…”

Guillain-Barre Syndrome Associated with Peginterferon Alfa-2a: A Case Report

“…Literatürde, PEG-İFN kullanımıyla ilişkili iki GBS olgusundan söz edilmektedir (4,5). Bizim olgumuzda yakınmaların IFN kullanımından hemen sonra ortaya çıkmasının yanında, GBS'nin tipik klinik bulgularına rastlanması, IVIG tedavisinin yanı sıra GBS'ye özgü rehabilitasyon programının da tedavi cevabını hızlandırma-sı çok önemliydi.…”

“…Daha az sıklıkla, tiroid disfonksiyonu, kilo kaybı, saç dökülme-si, pulmoner toksite, hipersensivite reaksiyonu, sarkoidoz, myastenia gravis, lupus, romatoid artrit, kolit ve görme kaybı ortaya çıkabildiği bilinmektedir (4). Periferal sinirleri etkileyen önemli nörolojik yan etkiler nadirdir.…”

Late primary cytomegalovirus infection presenting with acute inflammatory demyelinating polyneuropathy in a heart transplant recipient: a case report and review of the literature

“…There are several additional cases of non‐CMV associated GBS in SOT recipients reported in the literature. The proposed etiologies in these cases include Campylobacter infection, pegylated interferon, and immunosuppressive agents . There are numerous reports of GBS in hematopoietic stem cell transplant recipients and human immunodeficiency virus‐infected individuals, although these cases rarely show a clear association with CMV infection .…”