Guillain-Barré syndrome in northern China Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies

Abstract

Guillain-Barré syndrome has been considered to be primarily an acute inflammatory demyelinating polyneuropathy (AIDP). Our experience with Guillain-Barré syndrome in northern China differs from the traditional concept. Electrophysiologically and pathologically, most of our patients have motor axonal degeneration with minimal cellular inflammation, which we have termed 'acute motor axonal neuropathy' (AMAN). The current studies were undertaken to characterize prospectively the clinical, electrophysiological, and serological features of Guillain-Barré syndrome, defined clinically, in northern China. In 1991 and 1992, we characterized by electrodiagnostic criteria 129 Chinese patients with Guillain-Barré syndrome. The AMAN form was present in 65% of patients, the AIDP form in 24% and 11% were unclassifiable. For the 38 patients who presented from January to October, 1992, we performed serological assays for antibodies to Campylobacter jejuni and to glycolipids. Of these 38 patients, 55% had AMAN, 32% had AIDP and 13% were unclassifiable. Sixty-six percent of the 38 had serological evidence of recent C. jejuni infection as compared with 16% of village controls (P = 0.001). Seventy-six percent of AMAN patients and 42% of AIDP patients were seropositive. IgG anti-GM1 antibodies were more frequent in Guillain-Barré syndrome patients compared with village controls (42% versus 6%; P < 0.01). However, no statistically significant correlations were found between the pattern of disease, AMAN or AIDP, anti-glycolipid antibodies, or C. jejuni antibodies. Based on electrophysiological criteria, Guillain-Barré syndrome in northern China can be divided into two predominant forms: AIDP and AMAN. The AMAN form is more common and predominates in the yearly summer outbreaks of Guillain-Barré syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Guillain Barré syndrome in a population less than 15 years old in Brazil

“…Until mid 80's the acute poliomyelitis was the main cause of acute flaccid palsies but with the program of eradication of poliomyelitis had emerged the Guillain-Barré syndrome (GBS) as the major etiology, such statement is already proved in the developed countries, but still unknown in many communities. The epidemiological data has been shown valuable in evaluating the frequency of GBS in various populations, studying changes in incidence over time, detecting outbreaks or cluster of unusual preceding illnesses, and possible illuminating underlying causes 1,2 . Epidemiological surveillance of GBS is considerable relevant since large and small epidemics due to vaccines, water pollution, drugs, as well unexpected statistically significant variations in annual incidence in age sub-groups have been reported 3 .…”

Clinical profile of adults with Guillain Barre Syndrome in North-West Rajasthan, India

“…5 In Taiwan Lyu RK et al showed seasonal preponderance evident between March to May. 13 McKhann also found most cases of GBS occurring during the summer month and among children and young adult, most of which reside in rural area.…”

“…This observation is similar to study conducted by Ho et al and McKhann in China which also showed that more than half of the cases of Guillain Barre syndrome came from rural area. 5,14 The cause of its rural predominance is not known. It may be because of high incidence of respiratory, gastrointestinal illness, which goes untreated in rural area because of lack of awareness and unavailability of medical facility.…”

“…1 In these cases campylobacter enteritis, axonal damage and a positive response to anti-GMl antibodies were frequent finding. [2][3][4][5] The outcome of the disease is sometimes unfavourable and can be predicted by the presence of selected prognostic indicators. 6 Although Guillain Barre syndrome is consider to be related to antecedent infection, the detail mechanism is still unclear.…”

Guillain-Barré Syndrome

“…AMAN and AMSAN cases were originally described in northern China and are associated with Campylobacter Jejuni (C. Jejuni) infection, which is a poor prognostic factor [26]. Patients with AMAN have a rapid progression of weakness to an early nadir over a few days resulting in prolonged paralysis and respiratory failure [27].…”