KRATKOROČNI ISHOD GUILLAIN-BARRÉ-OVOG SINDROMA – ISKUSTVO IZ TERCIJARNOG CENTRA

Ivo M Božović; Bogdan Bjelica; Stefan Bošković; Ana Nikolić

doi:10.5937/mp67-12603

Ivo M Božović Univerzitet u Beogradu, Medicinski fakultet
Bogdan Bjelica Univerzitet u Beogradu, Medicinski fakultet
Stefan Bošković Univerzitet u Beogradu, Medicinski fakultet
Ana Nikolić Univerzitet u Beogradu, Medicinski fakultet, Klinički centar Srbije, Klinika za neurologiju

DOI: https://doi.org/10.5937/mp67-12603

Sažetak

Uvod: Guillain-Barré-ov sindrom (GBS) je akutno autoimuno oboljenje perifernih nerava i njihovih korijenova. Najčešće varijante oboljenja su: akutna inflamatorna demijelinizaciona polineuropatija (AIDP), akutna motorna aksonalna neuropatija (AMAN), akutna motorna i senzorna aksonalna neuropatija (AMSAN), Miller-Fisher-ov sindrom (MFS) i druge rijeđe forme.

Cilj: Procijena učestalosti različitih varijanti GBS kao i analiza kratkoročnog ishoda bolesti u kohorti bolesnika hospitalizovanih na Klinici za neurologiju Kliničkog Centra Srbije.

Materijal i metode: Istraživanje je obuhvatilo 43 bolesnika sa GBS, koji su hospitalizovani tokom 2015. godine. Podaci o kliničkim karakteristikama bolesti prikupljani su retrospektivnom analizom iz elektronske medicinske dokumentacije. U radu su korišćene metode deskriptivne statistike: srednja vrijednost, standardna devijacija i proporcija.

Rezultati: U našoj grupi je registrovana predominacija muškaraca (odnos muškarci - žene 2,6 : 1). Najučestalija varijanta kod nas je bila AIDP (41,9%), zatim AMSAN (7,0%) i AMAN (4,7%). Slabost i trnjenje u nogama (18,6%) bili su najčešći prvi simptomi bolesti. Većina pacijenata je na prijemu imala blagu funkcionalnu onesposobljenost procijenjenu Hughes-ovom skalom (65,1%), dok je u piku bolesti 62,8% pacijenta bilo nepokretno, a 2,3% bolesnika zahtijevalo je mehaničku ventilaciju. Ishod bolesti je kod 74,4% bio povoljan, dok je kod 11 bolesnika (25,6%) zaostala značajna funkcionalna onesposobljenost na otpustu. Kod 2 (4,7%) pacijenta naše kohorte zabilježen je letalni ishod.

Zaključak: GBS je bolest brzo progresivnog, monofaznog toka koja danas, zahvaljujući savremenoj terapiji, ima generalno dobru prognozu. Dalja naša istraživanja će biti usmjerena na praćenje dugotrajnog ishoda bolesti kod pacijenata sa GBS.

Biografija autora

Ivo M Božović, Univerzitet u Beogradu, Medicinski fakultet

Student

Reference

Pearce JM. Octave Landry's ascending paralysis and the Landry-Guillain-Barre-Strohl syndrome. J Neurol Neurosurg Psychiatry. 1997 May; 62(5):495,500.

Brody AJ, Sternbach G, Varon J. Octave Landry: Guillain-Barré syndrome. J Emerg Med 1994 Nov-Dec; 12(6):833-7.

Yoshikawa H. [Epidemiology of Guillain-Barré Syndrome]. Brain nerve = Shinkei kenkyū no shinpo. 2015; 67(11):1305–11.

Cuadrado JI, de Pedro-Cuesta J, Ara JR, Cemillán CA, Díaz M, Duarte J, et al. Guillain-Barré syndrome in Spain, 1985-1997: epidemiological and public health views. Eur Neurol. 2001; 46(2):83–91.

Peric S, Milosevic V, Berisavac I, Stojiljkovic O, Beslac-Bumbasirevic L, Marjanovic I, et al. Clinical and epidemiological features of Guillain-Barré syndrome in the Western Balkans. J Peripher Nerv Syst. 2014;19(4):317–21.

McGrogan A, Madle GC, Seaman HE, de Vries CS. The epidemiology of Guillain-Barré syndrome worldwide. A systematic literature review. Neuroepidemiology. 2009; 32(2):150–63.

Hernandez-Torruco J, Canul-Reich J, Frausto-Solis J, Mendez-Castillo JJ. Towards a predictive model for Guillain-Barré syndrome. Conf Proc . Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf . 2015; 2015:7234–7.

Blum S, Reddel S, Spies J, McCombe P. Clinical features of patients with Guillain-Barré syndrome at seven hospitals on the East Coast of Australia. J Peripher Nerv Syst. Wiley Periodicals, Inc.; 2013;18(4):316–20.

Cuadrado JI, de Pedro-Cuesta J, Ara JR, Cemillán CA, Díaz M, Duarte J, et al. Public health surveillance and incidence of adulthood Guillain-Barré syndrome in Spain, 1998-1999: the view from a sentinel network of neurologists. Neurol Sci. 2004;25(2):57–65.

Islam Z, Gilbert M, Mohammad QD, Klaij K, Li J, van Rijs W, et al. Guillain-Barré syndrome-related Campylobacter jejuni in Bangladesh: ganglioside mimicry and cross-reactive antibodies. PLoS One. 2012;7(8):e43976.

Van der Meché FG, Van Doorn PA, Meulstee J, Jennekens FG, GBS-consensus group of the Dutch Neuromuscular Research Support Centre. Diagnostic and classification criteria for the Guillain-Barré syndrome. Eur Neurol. 2001;45(3):133–9.

Hughes RA, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneuropathy. Lancet (London, England). 1978;2(8093):750–3.

Markoula S, Giannopoulos S, Sarmas I, Tzavidi S, Kyritsis AP, Lagos G. Guillain-Barré syndrome in northwest Greece. Acta Neurol Scand. 2007;115(3):167–73.

De la O-Peña D, Robles-Figueroa M, Chávez-Peña Q, Bedolla-Barajas M. [Features of Guillain-Barre syndrome in adults: results of a university hospital]. Rev médica del Inst Mex del Seguro Soc.2015;53(6):678–85.

Hughes RA, Rees JH. Guillain-Barré syndrome. Curr Opin Neurol. 1994;7(5):386–92.

Nyati KK, Nyati R. Role of Campylobacter jejuni infection in the pathogenesis of Guillain-Barré syndrome: an update. Biomed Res Int. 2013;2013:852195.

Yuki N. [Molecular Mimicry and Guillain-Barré Syndrome]. Brain nerve = Shinkei kenkyū no shinpo. 2015; 67(11):1341–6.

González-Suárez I, Sanz-Gallego I, Rodríguez de Rivera FJ, Arpa J. Guillain-Barré syndrome: natural history and prognostic factors: a retrospective review of 106 cases. BMC Neurol. 2013; 13:95.

Sejvar JJ, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter R, et al. Guillain-Barré syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2011; 29(3):599–612.

Hughes RAC, Cornblath DR. Guillain-Barré syndrome. Lancet (London, England). 2005;366 (9497):1653–66.

McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z, et al. Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in China. Ann Neurol. 1993; 33(4):333–42.

Zhang H-L, Wu J, Ni F-M, Islam Z, Mohammad QD, Endtz HP, et al. Axonal variant of Guillain-Barre syndrome associated with campylobacter infection in Bangladesh. Neurology. 2010; 75(2):194–5.

Yuki N, Hartung H-P. Guillain-Barré syndrome. N Engl J Med. 2012;366(24):2294–304.

Chiò A, Cocito D, Leone M, Giordana MT, Mora G, Mutani R. Guillain-Barré syndrome: a prospective, population-based incidence and outcome survey. Neurology. 2003; 60(7):1146–50.

Hughes RAC, Swan A V, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane database Syst Rev.2014;9:CD002063.