Systematic review of factors associated with the development of Guillain–Barré syndrome 2007–2017: what has changed?

Abstract

Objective The objective of this study was to describe the factors associated with the development of Guillain–Barré syndrome, both infectious and non‐infectious, during and after the A(H1N1) influenza pandemic in 2009 and the recent Zika virus epidemic in the Americas. Method Systematic review of literature on factors associated with the development of the Guillain–Barré syndrome published between 2007 and 2017 listed in EBSCO, MEDLINE and LILACS databases. The quality of the studies was evaluated using the Newcastle Ottawa Scale. Results Thirty‐four articles met inclusion criteria and were selected for analysis. Their quality was considered good in relation to most of the items evaluated. Many aetiological agents had the results of association with Guillain–Barré syndrome, among them Campylobacter jejuni, influenza vaccine – both pandemic and seasonal vaccines, respiratory infection, gastrointestinal infection among others. The aetiological agents found are, in most part, the same reported prior to the study period. The association with surgeries, chikungunya virus (CHIKV), Zika virus and quadrivalent human papillomavirus vaccine stand out as new aetiological agents in the list of the various possible agents that trigger Guillain–Barré syndrome reported in the study period. There were no Brazilian studies identified during this period. Conclusions The results of the review reaffirmed C. jejuni as the major trigger of GBS, whereas the association of influenza vaccines and GBS is less clear; Zika virus infection in association with GBS was found in only one study.

A horse and a zebra: an atypical clinical picture including Guillain-Barré syndrome, recurrent fever and mesenteric lymphadenopathy caused by two concomitant infections

“…The infection is usually self-limiting and does not require specific treatment, however, it can lead to severe immunological complications. Due to molecular mimicry between its lipooligosaccharides and host gangliosides, C. jejuni is the major trigger of GBS [6]. Here, it is associated with a pure motor syndrome, as it occurred in our patient, and a slower recovery [7].…”

Ulcerative Colitis in Hematological Malignancies: Paraneoplastic Manifestation or Coincidental Bystander?

“…Could the association of UC with hematological malignancies be due to a genetic predisposition, implicating the components of the MHC-I, HLA B7 supertype, as in these cases? Similarly, could this "paraneoplastic" extensive UC represent a distinct entity, a unique or specific UC phenotype similar to the one described for GBS associated with Campylobacter jejuni infection [20]?…”

“…e B07, a rather frequent allele, already linked to hematological malignancies [18], is also frequently encountered among Greek UC patients and associated with greater disease extent [19]. e presence of B35 has been documented in cases of cosegregated autoimmune disorders, such as UC and Takayasu arteritis, as well as UC and postinfectious Guillain-Barré syndrome (GBS) [20][21][22][23]. B51 shows a strong link with Adamantiades-Behcet [24] while B55 is involved in hepatitis C virus patient progress [25].…”

Neurological complications associated with emerging viruses in Brazil

“…Although the H1N1 epidemic in 2009 coincided with an increase in GBS, none of the patients whose charts we reviewed in 2015–2017 had symptoms of influenza or recent influenza vaccination. Epidemiological studies have not demonstrated a relationship between influenza vaccination and increased risk of GBS . GBS incidence may have been lower in the winter because arboviral infections happen predominantly in the summer, spring, and fall.…”