Guillain-Barre syndrome subtypes related to Campylobacter infection

J. Drenthen, N Yuki, J (Jan) Meulstee, EM Maathuis, Pieter van Doorn, GH Visser, JH Blok, B.C. Jacobs

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Abstract

Background In Guillain-Barre syndrome (GBS), the diversity in electrophysiological subtypes is unexplained but may be determined by geographical factors and preceding infections. Acute motor axonal neuropathy (AMAN) is a frequent GBS variant in Japan and one study proposed that in Japan, Campylobacter jejuni infections exclusively elicit AMAN. In The Netherlands C jejuni is the predominant type of preceding infection yet AMAN is rare. This may indicate that not all Dutch GBS patients with C jejuni infections have AMAN. Objective To determine if GBS patients with a preceding C jejuni infection in The Netherlands exclusively have AMAN. Methods Retrospective analysis of preceding infections in relation to serial electrophysiology and clinical data from 123 GBS patients. C jejuni related cases were defined as having preceding diarrhoea and positive C jejuni serology. Electrophysiological characteristics in C jejuni related cases were compared with those in viral related GBS patients. In addition, eight GBS patients from another cohort with positive stool cultures for C jejuni were analysed. Results 17 (14%) of 123 patients had C jejuni related GBS. C jejuni patients had lower motor and higher sensory action potentials compared with viral related cases. Nine (53%) C jejuni patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the criteria for acute inflammatory demyelinating polyneuropathy (AIDP). Also, two (25%) of eight additional patients with a C jejuni positive stool sample had AIDP. Conclusion In The Netherlands, C jejuni infections are strongly, but not exclusively, associated with axonal GBS. Some patients with these infections fulfil current criteria for demyelination.
Original languageUndefined/Unknown
Pages (from-to)300-305
Number of pages6
JournalJournal of Neurology Neurosurgery and Psychiatry
Volume82
Issue number3
DOIs
Publication statusPublished - 2011

Research programs

  • EMC MM-02-72-02
  • EMC MM-04-44-02

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