Guillain–Barré syndrome (GBS) represents a group of acute immune-mediated polyradiculoneuropathies that is usually characterized by symmetrical limb weakness and areflexia. GBS can also lead to atypical clinical findings, which may lead to confusion and errors in the diagnosis. In this report, we describe a case of Guillain–Barré syndrome in a 7-year-old child who presented with neck stiffness, headache and vomiting mimicking acute meningoencephalitis, arthritis and myositis. Symptoms of ascending paralysis developed subsequently. Clearly, the atypical presentation of GBS is a significant dilemma for pediatricians and may lead to delays in diagnosis and treatment.

/pdf/diagnostic-pitfalls-in-guillain-barre-syndrome-case-report-3kma9mu1.pdf

Diagnostic Pitfalls in Guillain–Barré Syndrome: Case Report and Literature Review

Guillain-Barré syndrome (GBS) is an acute inflammatory neuropathy. The Erasmus GBS Respiratory Insufficiency Score (EGRIS) and the modified Erasmus GBS Outcome Score (mEGOS) are prognostic models used in the prediction of mechanical ventilation and outcome. Thus far, there are only few biomarkers for the prognosis prediction of GBS patients, and albumin level is one that is promising. Patients diagnosed with GBS from 2013 to 2022 at Renmin Hospital, Wuhan University, China, were included. Patients hospitalized between 2016 and 2022 underwent short- and long-term follow-ups. The correlations between EGRIS/mEGOS and mechanical ventilation and outcome were evaluated. Serum albumin level was examined the day after admission. Furthermore, we also investigated whether the level of serum albumin was useful in predicting disease severity or poor outcome. In all, 145 patients were enrolled. Nineteen patients (13.1%) who required mechanical ventilation had higher Hughes GBS disability score (HGDS) at admission and discharge (P < 0.05 and P < 0.0001, respectively), shorter time from onset to admission and treatment (P < 0.01 and P < 0.001, respectively) and longer hospital stays (P < 0.001) than patients who did not require mechanical ventilation. High EGRIS scores were linked with the need for mechanical ventilation (r = 0.427, P < 0.001, AUC = 0.623). Seventy-one patients were admitted between 2016 and 2022. Of these, 65 patients had a 4-week follow-up and 61 had a 6-month follow-up. Higher mEGOS scores at admission and 7 days after admission significantly correlated with short- (P < 0.0001 and P < 0.0001) and long-term (P < 0.05 and P < 0.05) outcomes, respectively. No significant difference in outcome was found between different subtypes (4 weeks [P = 0.099] and 6 months [P = 0.172]). Patients with lower albumin level tended to have higher HGDS (at admission P < 0.05, at nadir P < 0.001, and at discharge P < 0.001) and higher properties of the need of mechanical ventilation (P < 0.05) and ICU stay (P < 0.05) than those with normal albumin levels. Those with low albumin levels were also unable to walk independently at 6 months (P < 0.01). mEGOS scores predicted the outcomes of GBS patients in China, and EGRIS score predicted the need for mechanical ventilation in these patients. Albumin level at admission correlated well with disease severity and outcomes. 

Predicting of Mechanical Ventilation and Outcomes by Using Models and Biomarker in Guillain-Barré Syndrome.

Introduction and Objective. Guillain-Barré syndrome (GBS) is a complex clinical entity with an autoimmune basis. It is considered the most common cause of acute neuromuscular paralysis in children. The incidence of GBS is approximately 0.34 per 100 000 cases annually, with a higher prevalence in the male population. The cause of the incidence is considered to be a complication of infection or vaccination. Review Methods. The studies cited in the presented review were selected from PUBMED. The key words used for the search included: ‘Guillain-Barré syndrom’, ‘Guillain-Barré treatment’, and ‘Guillain-Barré therapeutic methods’. Articles not written in English, conference abstracts only and duplicated papers were excluded. Brief

pdf/guillain-barre-syndrome-in-childhood-what-we-know-and-where-39aawejvk8.pdf

Guillain-Barré syndrome in childhood – what we know and where we are? A therapeutically difficult problem

Prognosis of <scp>Guillain–Barré</scp> syndrome in children: More questions to answer

Prognostic models for pediatric Guillain-Barré Syndrome: Europe is our playground.

To explore the clinical characteristics and prognostic predictors of Guillain–Barré syndrome (GBS) in Chinese paediatric patients.

Reliability and validity of prognostic indicators for Guillain–Barré syndrome in children

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Reliability and validity of prognostic indicators for Guillain–Barré syndrome in children