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GBS Patients (gb + patient)
Selected AbstractsStructure Of Campylobacter Jejuni Lipopolysaccharides Determines Antiganglioside Specificity And Clinical Features Of Guillain-Barre, And Miller Fisher PatientsJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2002CW Ang Ganglioside mimicry in the lipopolysaccharide (LPS) fraction of Campylobacter jejuni isolated from Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) patients was compared with isolates from patients with an uncomplicated enteritis. The antibody response to C. jejuni LPS and gangliosides in neuropathy patients and controls was compared as well. LPS from GBS and MFS-associated isolates more frequently contained ganglioside-like epitopes compared to control isolates. Almost all neuropathy patients showed a strong antibody response against LPS and multiple gangliosides in contrast to enteritis patients. Isolates from GBS patients more frequently had a GM1-like epitope than isolates from MFS patients. GQ1b-like epitopes were present in all MFS-associated isolates and was associated with anti-GQ1b antibody reactivity and the presence of oculomotor symptoms. These results demonstrate that the expression of ganglioside mimics is a risk factor for the development of post-Campylobacter neuropathy. This study provides additional evidence for the hypothesis that the LPS fraction determines the antiganglioside specificity and clinical features in post-Campylobacter neuropathy patients. [source] Contribution of central and peripheral factors to residual fatigue in Guillain,Barré syndromeMUSCLE AND NERVE, Issue 1 2007Marcel P.J. Garssen MD Abstract Many patients with Guillain,Barré syndrome (GBS) suffer from severe residual fatigue that has an uncertain basis. We determined the relative contribution of peripheral and central factors during a 2-min fatiguing sustained maximal voluntary contraction (MVC) in 10 neurologically well-recovered GBS patients and 12 age- and sex-matched healthy controls. Physiological fatigue was defined as the decline of voluntary force during an MVC of the biceps brachii. Relative amounts of peripheral fatigue and central activation failure were determined combining voluntary force and force responses to electrical stimulation. Surface electromyography was used to determine muscle-fiber conduction velocity. During the first minute of sustained MVC, peripheral fatigue developed more slowly in patients than in controls. Central fatigue only occurred in patients. The muscle-fiber conduction velocity was higher in patients. The initial MVC, decrease of MVC, initial force response, and initial central activation failure did not significantly differ between the groups. Although peripheral mechanisms cannot be excluded in the pathogenesis of residual fatigue after GBS, these results suggest that central changes are involved. This study thus provides further insight into the factors contributing to residual fatigue in GBS patients. Muscle Nerve, 2007 [source] Prediction of respiratory insufficiency in Guillain-Barré syndromeANNALS OF NEUROLOGY, Issue 6 2010Christa Walgaard MD Objective Respiratory insufficiency is a frequent and serious complication of the Guillain-Barré syndrome (GBS). We aimed to develop a simple but accurate model to predict the chance of respiratory insufficiency in the acute stage of the disease based on clinical characteristics available at hospital admission. Methods Mechanical ventilation (MV) in the first week of admission was used as an indicator of acute stage respiratory insufficiency. Prospectively collected data from a derivation cohort of 397 GBS patients were used to identify predictors of MV. A multivariate logistic regression model was validated in a separate cohort of 191 GBS patients. Model performance criteria comprised discrimination (area under receiver operating curve [AUC]) and calibration (graphically). A scoring system for clinical practice was constructed from the regression coefficients of the model in the combined cohorts. Results In the derivation cohort, 22% needed MV in the first week of admission. Days between onset of weakness and admission, Medical Research Council sum score, and presence of facial and/or bulbar weakness were the main predictors of MV. The prognostic model had a good discriminative ability (AUC, 0.84). In the validation cohort, 14% needed MV in the first week of admission, and both calibration and discriminative ability of the model were good (AUC, 0.82). The scoring system ranged from 0 to 7, with corresponding chances of respiratory insufficiency from 1 to 91%. Interpretation This model accurately predicts development of respiratory insufficiency within 1 week in patients with GBS, using clinical characteristics available at admission. After further validation, the model may assist in clinical decision making, for example, on patient transfer to an intensive care unit. ANN NEUROL 2010;67:781,787 [source] Pharmacokinetics of intravenous immunoglobulin and outcome in Guillain-Barré syndrome,ANNALS OF NEUROLOGY, Issue 5 2009Krista Kuitwaard MD Objective Intravenous immunoglobulin (IVIg) is the first choice treatment for Guillain-Barré syndrome (GBS). All patients initially receive the same arbitrary dose of 2g per kg body weight. Not all patients, however, show a good recovery after this standard dose. IVIg clearance may depend on disease severity and vary between individuals, implying that this dose is suboptimal for some patients. In this study, we determined whether the pharmacokinetics of IVIg is related to outcome in GBS. Methods We included 174 GBS patients who had previously participated in 2 randomized clinical trials. At entry, all patients were unable to walk unaided and received a standard dose of IVIg. Total IgG levels in serum samples obtained immediately before and 2 weeks after the start of IVIg administration were determined by turbidimetry and related to clinical outcome at 6 months. Results The increase in serum IgG (,IgG) 2 weeks after IVIg treatment varied considerably between patients (mean, 7.8g/L; standard deviation, 5.6g/L). Patients with a low ,IgG recovered significantly more slowly, and fewer reached the ability to walk unaided at 6 months (log-rank p < 0.001). In multivariate analysis adjusted for other known prognostic factors, a low ,IgG was independently associated with poor outcome (p = 0.022). Interpretation After a standard dose of IVIg treatment, GBS patients show a large variation in pharmacokinetics, which is related to clinical outcome. This may indicate that patients with a small increase in serum IgG level may benefit from a higher dosage or second course of IVIg. Ann Neurol 2009;66:597,603 [source] Immunoglobulin IgG Fc-receptor polymorphisms and HLA class II molecules in Guillain,Barré syndromeACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010S. Sinha Sinha S, Prasad KN, Jain D, Nyati KK, Pradhan S, Agrawal S. Immunoglobulin IgG Fc-receptor polymorphisms and HLA class II molecules in Guillain,Barré syndrome. Acta Neurol Scand: 2010: 122: 21,26. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objective,,, To analyze host genetic factors immunoglobulin G Fc receptors (Fc,Rs) and human leukocyte antigen (HLA) class II in GBS patients. Methods,,, Fc,RIIA, IIIA and IIIB polymorphisms were studied in 80 each GBS patients and healthy controls by allele specific PCR. HLA class II DR,1 and DQ,1 typing was performed at the two-digit level by PCR in randomly selected 54 GBS patients and 202 controls. Results,,, Fc,RIIA-H/H (56% vs 9%; P < 0.0001) and Fc,RIIIA-V/V (40% vs 13%; P < 0.0001) genotypes, H131 allele frequencies (0.73 vs 0.26, P < 0.0001) and HLA DQ,1*060x (OR, 1.96; 95% CI, 1.26,3.04; P < 0.01) were significantly increased in GBS than controls. DR,1*0701 alone (OR, 10; 95% CI, 45.90,2.25; P < 0.001) and together with Fc,RIIA-H/H (OR, 11.03; 95% CI, 2.63,46.20; P < 0.001) was significantly associated with GBS patients having microbiological evidence of recent infection. Conclusions,,, The study indicates that homozygous Fc,RIIA and Fc,RIIIA genotypes and Fc,RIIA H131 allele are associated with GBS. HLA class II molecule DR,1*0701 is identified as novel genetic risk factor for development of GBS in patients with preceding infection. [source] Tongue weakness is associated with respiratory failure in patients with severe Guillain-Barré syndromeACTA NEUROLOGICA SCANDINAVICA, Issue 6 2009D. Orlikowski Objective,,, Swallowing impairment may worsen respiratory weakness and conduct to respiratory complications such as aspiration pneumonia in Guillain-Barré syndrome (GBS). We prospectively evaluate how tongue weakness could be associated to bulbar dysfunction and respiratory weakness in severe GBS patients. Measurements and main results,,, Tongue strength, dysphagia and respiratory parameters were measured in 16 GBS patients at intensive care unit (ICU) admission and discharge and in seven controls. Tongue strength was decreased in the GBS patients compared with the controls. At admission, patients with dysphagia and those requiring mechanical ventilation (MV) had greater tongue weakness. All the patients with initial tongue strength <150 g required MV during ICU stay. Tongue strength correlated significantly with respiratory parameters. Conclusion,,, This study confirms the strong association between bulbar and respiratory dysfunction in GBS admitted to ICU. Tongue weakness may be present in GBS, especially during the phase of increasing paralysis, and resolves during the recovery phase. Tongue strength and indices of global and respiratory strength vary in parallel throughout the course of GBS. Further studies are needed to assess if, when used in combination with other respiratory tests, tongue strength measurement could contribute to identify patients at high risk for respiratory complications. [source] Phrenic nerve conduction in the early stage of Guillain,Barre syndrome might predict the respiratory failureACTA NEUROLOGICA SCANDINAVICA, Issue 4 2007H. Ito Objective,,, To investigate whether phrenic nerve conduction in the early phase of Guillain, Barre syndrome (GBS) predicts the need for respiratory assistance during the subsequent clinical course. Material and methods,,, We performed electrophysiological examinations of conventional peripheral nerve conduction and phrenic nerve conduction for GBS patients within 14 days from the onset. We excluded patients who had already been treated with immuno-related therapy and respiratory assistance. Results,,, Fifteen patients were enrolled. Three patients with the sum of phrenic nerve latency longer than 30 ms and the sum of bilateral diaphragmatic compound muscle action potential amplitude smaller than 0.3 mV required respiratory assistance after the conduction test. Conclusion,,, Our findings showed that not only delayed distal latency but also decreased amplitude may predict the need for respiratory assistance during the subsequent disease course. [source] | ||||||||||