Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome

Guillain-Barré syndrome (GBS) is an important cause of acute neuromuscular paralysis. Molecular mimicry and a cross-reactive immune response play a crucial part in its pathogenesis, at least in those cases with a preceding Campylobacter jejuni infection and with antibodies to gangliosides. The type...

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Vydáno v:Lancet neurology Ročník 7; číslo 10; s. 939 - 950
Hlavní autoři: van Doorn, Pieter A, Ruts, Liselotte, Jacobs, Bart C
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Elsevier Ltd 01.10.2008
Elsevier Limited
Témata:
Apheresis
Autonomic Nervous System Diseases - etiology
Campylobacter
Campylobacter jejuni
Disease Progression
Epidemiology
Fatigue
Gangliosides
Guillain-Barre syndrome
Guillain-Barre Syndrome - complications
Guillain-Barre Syndrome - epidemiology
Guillain-Barre Syndrome - etiology
Guillain-Barre Syndrome - therapy
Humans
Immune response
Immunoglobulins
Immunoglobulins, Intravenous - immunology
Immunoglobulins, Intravenous - therapeutic use
Infection
Infections
Influenza
Intravenous administration
Miller-Fisher syndrome
Neurology
Pain
Paralysis
Pathogenesis
Patients
Poliomyelitis
Prognosis
Proteins
Treatment Outcome
Vaccines
West Nile virus
United States > US
ISSN:1474-4422, 1474-4465
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Shrnutí:Guillain-Barré syndrome (GBS) is an important cause of acute neuromuscular paralysis. Molecular mimicry and a cross-reactive immune response play a crucial part in its pathogenesis, at least in those cases with a preceding Campylobacter jejuni infection and with antibodies to gangliosides. The type of preceding infection and patient-related host factors seem to determine the form and severity of the disease. Intravenous immunoglobulin (IVIg) and plasma exchange are effective treatments in GBS; mainly for practical reasons, IVIg is the preferred treatment. Whether mildly affected patients or patients with Miller Fisher syndrome also benefit from IVIg is unclear. Despite medical treatment, GBS often remains a severe disease; 3–10% of patients die and 20% are still unable to walk after 6 months. In addition, many patients have pain and fatigue that can persist for months or years. Advances in prognostic modelling have resulted in the development of a new and simple prognostic outcome scale that might also help to guide new treatment options, particularly in patients with GBS who have a poor prognosis.
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ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(08)70215-1