Guillain–Barré syndrome associated with the D222E variant of the 2009 pandemic influenza A (H1N1) virus: Case report and review of the literature

Cortese, Andrea; Baldanti, Fausto; Carnevale, L; Minoli, Lorenzo; Lozza, Alessandro; Marchioni, Enrico

doi:10.1016/j.jns.2011.08.047

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…Guillain‐Barre syndrome secondary to influenza infection was first described in 1959, and five adult cases have been reported since . Two of the 5 patients (40%) were women, and 4 of 5 (80%) were under the age of 40.…”

Section: Resultsmentioning

confidence: 99%

The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection

Sellers

Hagan

Hayden

et al. 2017

Influenza Resp Viruses

337

308

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Severe influenza infection represents a leading cause of global morbidity and mortality. Although influenza is primarily considered a viral infection that results in pathology limited to the respiratory system, clinical reports suggest that influenza infection is frequently associated with a number of clinical syndromes that involve organ systems outside the respiratory tract. A comprehensive MEDLINE literature review of articles pertaining to extra‐pulmonary complications of influenza infection, using organ‐specific search terms, yielded 218 articles including case reports, epidemiologic investigations, and autopsy studies that were reviewed to determine the clinical involvement of other organs. The most frequently described clinical entities were viral myocarditis and viral encephalitis. Recognition of these extra‐pulmonary complications is critical to determining the true burden of influenza infection and initiating organ‐specific supportive care.

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Section: Resultsmentioning

confidence: 99%

The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection

Sellers

Hagan

Hayden

et al. 2017

Influenza Resp Viruses

337

308

View full text Add to dashboard Cite

show abstract

“…Recent infectious diseases caused by agents such as Zika virus, Dengue virus, Chikungunya virus or influenza virus as primary triggers of GBS can be ruled out if the onset of the neurological signs and symptoms occurs during the dry season, or when no infectious disease outbreak is recorded where the patient lives or the place the patient has visited on travel. Viral infections typically present a seasonality pattern with a peak during the wet season (Cao‐Lormeau et al, ; Cortese et al, ; Oehler et al, ; Pastula et al, ; Ralapanawa, Kularatne, & Jayalath, ; Simon et al, ). Other exclusion criteria include a clinical presentation that may not fit completely to infection, e.g., no myalgia, no joint pain, no retrobulbar pain, no sign or symptoms suggestive of Campylobacter enteritis or Mycoplasma infection as possible triggers of GBS (Ang et al, ; Sharma et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…However, it is interesting that an association between HPV vaccination and GBS is frequently made, in spite of GBS following HPV vaccination being a very rare event (Katoulis et al, 2010;Ojha et al, 2014). Cortese et al, 2012;Oehler et al, 2015;Pastula et al, 2017;Ralapanawa, Kularatne, & Jayalath, 2015;Simon et al, 2016). Other exclusion criteria include a clinical presentation that may not fit completely to infection, e.g., no myalgia, no joint pain, no retrobulbar pain, no sign or symptoms suggestive of Campylobacter enteritis or…”

Section: Arsenic Neuropathymentioning

confidence: 99%

Chronic arsenic intoxication diagnostic score (CAsIDS)

Dani

Walter

2017

J of Applied Toxicology

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Arsenic and its compounds are well-established, potent, environmentally widespread and persistent toxicants with metabolic, genotoxic, mutagenic, teratogenic, epigenetic and carcinogenic effects. Arsenic occurs naturally in the Earth's crust, but anthropogenic arsenic emissions have surmounted the emissions from important natural sources such as volcanism. Inorganic arsenicals exhibit acute and chronic toxicities in virtually all cell types and tissues, and hence arsenic intoxication affects multiple systems. Whereas acute arsenic intoxication is rare and relatively easy to diagnose, chronic arsenic intoxication (CAsI) is common but goes often misdiagnosed.Based on a review of the literature as well as our own clinical experience, we propose a chronic arsenic intoxication diagnostic score (CAsIDS). A distinctive feature of CAsIDS is the use of bone arsenic load as an essential criterion for the individual risk assessment of chronic arsenic intoxication, combined with a systemic clinical assessment. We present clinical examples where CAsIDS is applied for the diagnosis of CAsI, review the main topics of the toxicity of arsenic in different cell and organ systems and discuss the therapy and prevention of disease caused or aggravated by chronic arsenic intoxication. CAsIDS can help physicians establish the diagnosis of CAsI and associated conditions.

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“…The mutation D222E in the haemagglutinin gene has been identified in a previously healthy 30 year old who suffered from Guillain-Barré Syndrome [59], however it is not clear whether the Guillain-Barré Syndrome was a result of the D222E. The D222E mutation was also detected by Puzelli et al [49] & Miller et al [60].…”

Section: D222e*mentioning

confidence: 94%

Risk Factors Associated with Severe Clinical Outcomes of Pandemic H1N1 Infection

Fullen¹

2014

JHVRV

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The clinical outcome of pandemic H1N1 influenza infection is dependent on the interplay of virus and host factors. Influenza virus infections can range from relatively mild infections of the upper respiratory tract to fatal disease of the lower respiratory tract. A range of host factors play a role in the severity of clinical disease in pdm(H1N1)09 infection. With the exception of neonates age was directly proportional to the severity of clinical outcome; obesity, COPD and pregnancy play a key role in clinical outcome of infection. An important determinant in the pathogenesis of influenza infection is the tissue tropism of the influenza virus. The D222G and D222N mutations of pdm(H1N1)09 influenza appear to have an increased tropism for the tissues of the lower respiratory tract and are disproportionally associated with severe clinical disease. These α2-3 salicylic acid tropic mutations, which have been associated with fatal cases of influenza infection, have also been preferentially selected for during sequential passage in embryonated eggs and viruses of avian origin. KeywordsInfluenza; Pandemic; H1N1; pdm(H1N1)09; Oseltamivir IntroductionThe current H1N1 influenza vaccine strain A/ California/7/2009 has a surprisingly high no detectable antibody (NDA) rate of approximately 52% in a population of 200 subjects screened (unpublished data). Studies have shown that the A/California/7/2009 strain of pandemic H1N1 influenza causes alveolar haemorrhage in the ferret model [1,2]; similar "swine flu" viruses A/Mexico/4482/2009 and A/ Netherlands/602/2009 also presented severe pathology in the ferret model [3,4]. As a consequence it is clear that infection with this group of viruses represents a significant risk of a severe clinical outcome. Furthermore, the severe symptoms that are associated with a subset of A/California/7/2009 infections are atypical for previous seasonal influenza infections. Co-morbidities and their impact on clinical outcome of infectionThe clinical outcomes of infection by pdm(H1N1)09 are considerably affected by one or more host factors and comorbidities. Here we discuss these co-morbidities and the impact that they have on clinical consequences to infection. Case fatality ratiosBy July 2009 63,479 cases of influenza like illness were reported in Mexico; of these cases 11% (6,945) were confirmed as H1N1 influenza; 92% of confirmed positive cases (6,407) were treated as outpatients, 7% (475) were admitted to hospital and survived and <1% died (63) [5]. During the early phase of the pandemic the case fatality ratio (CFR) was calculated to be approximately 0.4-0.6% [6]. In the UK an estimated 540,000 people had symptomatic H1N1 infection during a study period with a CFR of (0.026%) 26 deaths per 100,000 [7]. There is little published information for the CFRs of seasonal H1N1 or H3N2 influenza. However using data from the Health Protection Agency (HPA) we were able to determine the CFR for influenza infections admitted to intensive care units (ICU). 2/7 SymptomsA meta-analysis of H1N1...

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Guillain–Barré syndrome associated with the D222E variant of the 2009 pandemic influenza A (H1N1) virus: Case report and review of the literature

Cited by 15 publications

References 22 publications

The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection

The hidden burden of influenza: A review of the extra‐pulmonary complications of influenza infection

Chronic arsenic intoxication diagnostic score (CAsIDS)

Risk Factors Associated with Severe Clinical Outcomes of Pandemic H1N1 Infection

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