How Different is AMAN from AIDP in Childhood GBS? A Prospective Study from North India

Gupta, Pradeep Kumar; Singhi, Pratibha; Singhi, Sunit; Kasinathan, Ananthanarayanan; Sankhyan, Naveen

doi:10.1007/s12098-018-2835-5

Cited by 17 publications

(11 citation statements)

References 16 publications

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“…A few have documented acute motor axonal neuropathy as the commonest Guillain-Barre syndrome subtype, 34,35 whereas others have reported acute inflammatory demyelinating polyneuropathy as the most common prototype. 36 -38 A study on children in North India identified acute motor axonal neuropathy as the predominant subtype. 39…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile and Predictors of Mechanical Ventilation in Guillain-Barre Syndrome in North Indian Children

et al. 2020

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Objective: To describe the clinical-laboratory profile of pediatric Guillain-Barre syndrome and delineate features associated with need of mechanical ventilation. Methods: In a prospective observational study at tertiary care hospital, clinical-laboratory assessment and nerve conduction studies were documented in consecutive children hospitalized with Guillain-Barre syndrome according to Brighton criteria. Clinical-laboratory features were compared between ventilated and nonventilated patients using univariate and multivariate analysis. Results: Forty-six children (27 boys) with a mean age of 69.1±35.2 months were enrolled. History of preceding infection was present in 47.8%, bulbar palsy in 43.5%, feeble voice in 41.3%, sensory involvement in 13%, and autonomic involvement in 39.5%. Tetraparesis was noted in 87% of cases. Hughes disability scale >3 was noted in 44 children at admission and 39 (84.7%) at discharge. The most common electrophysiological type was acute motor axonal neuropathy (46.5%) followed by acute motor sensory axonal neuropathy (39.5%), acute inflammatory demyelinating polyneuropathy (7%), and inexcitable nerves (7%). Nine (19.7%) children were ventilated, 3 (6.5%) died or were lost, and 43 were discharged. Factors associated with need of mechanical ventilation on univariate analysis were older age, hypertension, bulbar palsy, feeble voice, lower Medical Research Council (MRC) sum, raised total leucocyte count, and history of preceding infection. Logistic regression revealed older age, history of predisposing illness, lower MRC sum at presentation, and bulbar palsy as independent predictors of mechanical ventilation. Conclusions: The most common electrophysiological subtype in northern Indian children is acute motor axonal neuropathy. Older age, preceding infection, low MRC sum, and bulbar palsy are predictors of mechanical ventilation in pediatric Guillain-Barre syndrome.

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Section: Discussionmentioning

confidence: 99%

Clinical Profile and Predictors of Mechanical Ventilation in Guillain-Barre Syndrome in North Indian Children

et al. 2020

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“…Patients with AMAN have a more rapid progression of weakness to an earlier nadir than in AIDP resulting in prolonged paralysis and respiratory failure over a few days. 12 The distinction seems clear conceptually, but the borders between the 2 conditions are not well defined. The electrophysiological findings are sometimes ambiguous, as they indicate AIDP in the early phases and AMAN later, or both conditions simultaneously.…”

Section: Discussionmentioning

confidence: 99%

The relationship between serum cystatin C levels and Hughes motor scale in Guillain-Barré syndrome

Chen

Shi

Fan

et al. 2022

NSJ

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Hughes ‫ومقياس‬ )cysC( ‫سيستاتني‬ ‫مصل‬ ‫مستويات‬ ‫بني‬ ‫والعالقة‬ .GBS ‫في‬ )HMS( ‫احلركي‬ ‫جيالن‬ ‫ملتالزمة‬ ‫مريض‬ 101 ‫مراجعة‬ ‫على‬ ‫الدراسة‬ ‫اشتملت‬ ‫املنهجية:‬ ‫أجرنا‬ ‫رجعي.‬ ‫بأثر‬ ‫0202م‬ ‫ويناير‬ ‫7102م‬ ‫يناير‬ ‫من‬ ‫الفترة‬ ‫خالل‬ ‫باريه‬ ‫املساعدة.‬ ‫والفحوصات‬ ‫السريرية‬ ‫واملظاهر‬ ‫الوبائية‬ ‫للخصائص‬ ‫تقييم‬ ‫حتليل‬ ‫أجرينا‬ ‫العجز.‬ ‫ذروة‬ ‫لقياس‬ HMS ‫مقياس‬ ‫استخدمنا‬ ‫كما‬ ‫ومتعددة‬ ‫املتغير‬ ‫أحادية‬ ‫حتليالت‬ ‫بواسطة‬ GBS ‫لشدة‬ ‫املؤثرة‬ ‫للعوامل‬ ‫املتغيرات.‬ ‫في‬ ‫ملحوظ‬ ‫بشكل‬ ‫أعلى‬ ‫الدم‬ ‫في‬ cysC ‫مستويات‬ ‫كانت‬ ‫النتائج:‬ )0.85-1.20( 0.98 ‫اخلفيفة‬ ‫املجموعة‬ ‫في‬ ‫منها‬ ‫الشديدة‬ ‫املجموعة‬ ‫إيجابي‬ ‫ارتباط‬ ‫هناك‬ ‫وكان‬ ،p=0.004 ،)0.76-0.95( 0.81 ‫مقابل‬ ‫جيالن‬ ‫مرضىمتالزمة‬ ‫في‬ HMS ‫و‬ ‫الدم‬ ‫في‬ cysC ‫مستويات‬ ‫بني‬ ‫كان‬ ‫املتغيرات،‬ ‫متعدد‬ ‫التحليل‬ ‫في‬ .)r=0.376, p=0.001( ‫باريه‬ ‫ذروة‬ ‫حتى‬ ‫والوقت‬ ،)p=0.003( ‫التنفسي‬ ‫اجلهاز‬ ‫عضالت‬ ‫شلل‬ )p=0.045( ‫املصل‬ ‫في‬ cysC ‫مستويات‬ ‫و‬ ،)p=0.017( ‫العجز‬ ‫وظيفية‬ ‫لنتائج‬ ‫مستقلة‬ ‫خطر‬ ‫عوامل‬ )p=0.015( ‫الدم‬ ‫صوديوم‬ ‫ونقص‬ ‫والشلل‬ cysC ‫مصل‬ ‫مستويات‬ ‫بني‬ ‫اجلمع‬ ‫كان‬ .)HMS>3( ‫سيئة‬ ‫عضالت‬ ‫شلل‬ ‫من‬ ‫املرض‬ ‫شدة‬ ‫لتقييم‬ ‫قيمة‬ ‫أكثر‬ ‫التنفسي‬ ‫العضلي‬ .)p=0.001 ، 0.787 ‫مقابل‬ AUC 0.863( ‫وحده‬ ‫التنفسي‬ ‫اجلهاز‬

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“…The inbalance in IgG1-/IgG3-subclass proportion could have consequences in pathology development, since IgG3-subclass has a better complement activator ability than IgG1 25 albeit its three-times shorter plasma half-life 20 . Considering antibodies against terminal NeuNAcα2,3Gal epitope have been preferentially associated with axonal damage 51 , one can speculate that the higher biological activity of IgG3 can have an influence on the greater severity and slower recovery observed in the axonal forms (compared to demyelinating variants) of Guillain-Barré syndrome 52 .…”

Section: Discussionmentioning

confidence: 99%

Neurological disorders-associated anti-glycosphingolipid IgG-antibodies display differentially restricted IgG subclass distribution

Lardone

Irazoqui

Nores

2020

Sci Rep

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Antibodies against several self-glycans on glycosphingolipids are frequently detected in different neurological disorders. Their pathogenic role is profusely documented, but the keys for their origin remain elusive. Additionally, antibodies recognizing non-self glycans appear in normal human serum during immune response to bacteria. Using HPTLC-immunostaining we aimed to characterize IgM and IgG subclass antibody responses against glycosphingolipids carrying self glycans (GM1/GM2/GM3/ GD1a/GD1b/GD3/GT1b/GQ1b) and non-self glycans (Forssman/GA1/"A" blood group/Nt7) in sera from 27 randomly selected neurological disorder patients presenting IgG reactivity towards any of these antigens. Presence of IgG2 (p = 0.0001) and IgG1 (p = 0.0078) was more frequent for IgG antibodies against non-self glycans, along with less restricted antibody response (two or more simultaneous IgG subclasses). Contrariwise, IgG subclass distribution against self glycans showed clear dominance for IgG3 presence (p = 0.0017) and more restricted IgG-subclass distributions (i.e. a single IgG subclass, p = 0.0133). Interestingly, anti-self glycan IgG antibodies with simultaneous IgM presence had higher proportion of IgG2 (p = 0.0295). IgG subclass frequencies were skewed towards IgG1 (p = 0.0266) for "anti-self glycan A" subgroup (GM2/GM1/GD1b) and to IgG3 (p = 0.0007) for "anti-self glycan B" subgroup (GM3/GD1a/GD3/GT1b/GQ1b). Variations in players and/or antigenic presentation pathways supporting isotype (M-G) and IgG-subclass pattern differences in the humoral immune response against glycosphingolipids carrying non-self versus self-glycans are discussed.

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How Different is AMAN from AIDP in Childhood GBS? A Prospective Study from North India

Cited by 17 publications

References 16 publications

Clinical Profile and Predictors of Mechanical Ventilation in Guillain-Barre Syndrome in North Indian Children

Clinical Profile and Predictors of Mechanical Ventilation in Guillain-Barre Syndrome in North Indian Children

The relationship between serum cystatin C levels and Hughes motor scale in Guillain-Barré syndrome

Neurological disorders-associated anti-glycosphingolipid IgG-antibodies display differentially restricted IgG subclass distribution

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