Guillain-Barre syndrome masquerading as acute respiratory failure in an infant

Abstract

Guillain-Barré syndrome (GBS) is a rare entity in infants. We report a case of GBS in a 5-month-old girl. The child presented with cough, loose stools, breathing difficulty, and listlessness. The child was treated as pneumonia with respiratory failure. Due to difficulty in weaning from ventilation with areflexia, marked hypotonia, and reduced power in all four limbs; possibilities of spinal muscular atrophy, poliomyelitis, and myopathies were kept. Nerve conduction velocity study was suggestive of mixed sensory-motor, severe axonal, and demyelinating polyradiculoneuropathy. Cerebrospinal fluid study revealed albuminocytological dissociation. Child was diagnosed as GBS and treated with intravenous immunoglobulin. Child recovered completely on follow-up. GBS should be considered as a differential diagnosis in acute onset respiratory failure with neuromuscular weakness in infants.

Predicting respiratory failure and outcome in pediatric Guillain-Barré syndrome

“…After reaching a plateau phase most patients start recovering but the rate and extent of recovery is highly variable [5,6]. The uncertainty of the clinical course in individual patients complicates the treatment and care, as indicated for example by the need for emergency intubation in children with GBS [7,8]. Accurate prediction models may early identify patients at risk of respiratory failure or of poor recovery which may help preventing emergencies or identify patients for future more intensive treatment.…”

Respiratory failure as first presentation of myasthenia gravis: a case report

“…Cases of ALS with respiratory failure as the first symptom are rarely reported. Kishore et al 29 reported a case of GBS in a 5-month-old girl. The child presented with cough, loose stools, breathing difficulty, and listlessness, and she was treated for pneumonia with respiratory failure.…”