Clinical and serological prognostic factors in childhood Guillain-Barré syndrome: A prospective cohort study in Bangladesh

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  • Imran Hasan
  • Nowshin Papri
  • Shoma Hayat
  • Israt Jahan
  • Ara, Gulshan
  • Badrul Islam
  • Zhahirul Islam

Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. The objective of this study was to investigate the preceding infections, clinical, serological and electrophysiological characteristics and outcome of childhood GBS in Bangladesh. We included 174 patients with GBS aged <18 years from a prospective cohort in Bangladesh between 2010 and 2018. We performed multivariate logistic regression to determine the risk factors for poor outcome. Among 174 children with GBS, 74% (n = 129) were male. Around half of the patients (49%, n = 86) had severe muscle weakness, 65% (n = 113) were bedbound (GBS disability score 4) and 17% (n = 29) patients required mechanical ventilation at admission. Campylobacter jejuni serology and anti-GM1 IgG antibody were positive in 66% and 21% of the patients respectively. One hundred and forty-three (82%) patients did not receive standard treatment and half of them recovered fully or with minor deficits at 6-month. Twenty patients (11%) died throughout the study period. At 3-month of onset of weakness, complete recovery or recovery with minor deficit was significantly higher in demyelinating GBS patients compared to axonal GBS patients (86% vs 51%, P =.001). Cranial nerve palsy (OR = 4.00, 95%CI = 1.55-10.30, P =.004) and severe muscle weakness (OR = 0.16, 95%CI = 0.06-0.45, P =.001) were the important risk factors of poor outcome in children with GBS. Further large-scale studies are required for better understanding of factors associated with mortality and morbidity in childhood GBS.

OriginalsprogEngelsk
TidsskriftJournal of the Peripheral Nervous System
Vol/bind26
Udgave nummer1
Sider (fra-til)83-89
Antal sider7
ISSN1085-9489
DOI
StatusUdgivet - 2021
Eksternt udgivetJa

Bibliografisk note

(Ekstern)

Funding Information:
The study was funded by icddr,b and Government of Bangladesh. icddr,b is grateful to the Governments of Bangladesh, Canada, Sweden and the UK for providing core/unrestricted support. Special thanks to Prof. Quazi Deen Mohammad for supporting to develop the primary cohort of GBS patients in Bangladesh. We acknowledge all study staffs who contributed in patient enrollment, data collection and specimen collection and storage. We are indebted to all neurologists who referred patients to us. We would also like to thank all study participants.

Publisher Copyright:
© 2021 Peripheral Nerve Society.

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