Primary Cytomegalovirus Infection Causing Guillain-Barré Syndrome in a Living Renal Allograft Recipient

Merzkani, Massini; Israel, Ezra; Sachdeva, Mala

doi:10.1155/2017/7264793

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…We identified 17 cases of GBS post‐renal transplantation in the 15 manuscripts (Table ) . The majority of cases were in males (81%) and patients who received transplants from deceased donors (87%).…”

Section: Resultsmentioning

confidence: 99%

Guillain‐Barré syndrome post renal transplant: A systematic review

Ostman

Chacko

2018

Transplant Infectious Dis

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Background Guillain‐Barré syndrome (GBS) is a common ascending polyneuropathy in adults. It is often associated with preceding viral or diarrhoeal illness with cytomegalovirus (CMV), Epstein‐Barr virus (EBV), or Campylobacter jejuni. Solid organ transplant recipients are more susceptible to opportunistic infections with CMV than the general population as a result of immunosuppressive therapies to prevent graft rejection. However, reports of GBS are rare in this population. Objective To systematically review cases of GBS in renal transplant patients to evaluate causative pathogens or triggers, management and associated morbidity and mortality. Methods and results We conducted a systematic search of the MEDLINE database uncovering 17 cases of GBS in renal transplant patients in the literature. The majority of cases were in males (81%) and patients who received deceased donor renal transplants (87%). The mean age was 44.7 years (SD 13). The time between transplant and onset of symptoms ranged from 2 days to 10 years (Mean = 720 days). GBS was commonly associated with antecedent viral (CMV 12; EBV 1) or diarrhoeal (2) illness while two cases were attributed to calcineurin inhibitor use. All patients recovered fully or partially after treatment with anti‐viral or anti‐bacterial agents, immunoglobulins, and/or plasma exchange. Conclusion Cytomegalovirus is the most common trigger for GBS in the post‐renal transplant setting. Other triggers include campylobacter jejuni and calcineurin inhibitors. GBS should be considered in transplant patients presenting with weakness or paralysis in order to institute timely management.

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Section: Resultsmentioning

confidence: 99%

Guillain‐Barré syndrome post renal transplant: A systematic review

Ostman

Chacko

2018

Transplant Infectious Dis

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“…In one case series, five patients with confirmed COVID‐19 developed symptoms of acute Guillain‐Barre syndrome, such as lower limb weakness and paresthesia, 5 to 10 days after the onset of COVID‐19 symptoms 23 . This is similar to the interval between the onset of symptoms of other viral infections, such as the Zika virus and Cytomegalovirus, and Guillain‐Barre syndrome 24,25 . Interestingly, in another case report, the order of symptoms was different 26 .…”

Section: Extrapulmonary and Atypical Clinical Features Of Covid‐19mentioning

confidence: 84%

“…23 This is similar to the interval between the onset of symptoms of other viral infections, such as the Zika virus and Cytomegalovirus, and Guillain-Barre syndrome. 24,25 Interestingly, in another case report, the order of symptoms was different. 26 Although the CSF analysis showed evidence of CNS infection, the RT-PCR failed to detect SARS-CoV-2 genetic materials in the CSF.…”

Section: Pulmonary Embolismmentioning

confidence: 92%

Extrapulmonary and atypical clinical presentations of COVID‐19

Abobaker

Raba

Alzwi³

2020

Journal of Medical Virology

103

100

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The novel coronavirus (SARS-CoV2) has led to an outbreak of multiple cases of pneumonia in Wuhan city in December 2019. The disease caused by this virus was named coronavirus disease 2019 or "COVID-19", which was declared by the World Health Organization as a global pandemic in March 2020. It typically presents with respiratory symptoms and febrile illness. However, there are few reported extrapulmonary and atypical presentations, such as hemoptysis, cardiac, neurological, gastrointestinal, ocular, and cutaneous manifestations, as well as venous and arterial thrombosis. Lack of awareness of these presentations might lead to misdiagnosis, delayed diagnosis, and isolation of suspected patients which increases the risk of transmission of infection between patients and doctors. All these issues will be discussed in this review.

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“…[15,16] Infection by Campylobacter jejuni is identified as the most common inciting event although other agents such as herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), Zika virus (ZIKV), Mycoplasma pneumoniae, Haemophilus influenza, and influenza have been reported. [7,[17][18][19][20][21][22] Vaccination to influenza has been implicated in GBS, although the evidence for this link is controversial. [23]…”

Section: Guillain-barré Syndrome: Symptoms and Causesmentioning

confidence: 99%

Influenza vaccination and Guillain–Barré syndrome: Reality or fear

Babazadeh

Afshar

Javanian

et al. 2019

Journal of Translational Internal Medicine

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Guillain–Barré syndrome (GBS) is an inflammatory disorder and an acute immune-mediated demyelinating neuropathy that causes reduced signal transmissions, progressive muscle weakness, and paralysis. The etiology of the syndrome still remains controversial and uncertain. GBS can be initiated and triggered by respiratory tract infections such as influenza, and intestinal infections such as Campylobacter jejuni. In addition, there is considerable evidence suggesting links between influenza vaccination and GBS. As reported previously, the incidence of GBS in individuals receiving swine flu vaccine was about one to two cases per million. Despite the influenza vaccine efficacy, its association with an immune-mediated demyelinating process can be challenging as millions of people get vaccinated every year. In this review we will discuss the association between influenza infection and vaccination with GBS by focusing on the possible immunopathological mechanisms.

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Primary Cytomegalovirus Infection Causing Guillain-Barré Syndrome in a Living Renal Allograft Recipient

Cited by 9 publications

References 20 publications

Guillain‐Barré syndrome post renal transplant: A systematic review

Guillain‐Barré syndrome post renal transplant: A systematic review

Extrapulmonary and atypical clinical presentations of COVID‐19

Influenza vaccination and Guillain–Barré syndrome: Reality or fear

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