Guillain-Barré syndrome subtypes related to Campylobacter infection

Judith Drenthen (1) , Nobuhiro Yuki (2) , Jan Meulstee (3) , Ellen M Maathuis (1) , Pieter A Doorn Van (1) , Gerhard H Visser (1) , Joleen H Blok (1) , Bart C Jacobs (1)

1 Erasmus MC - Erasmus University Medical Center [Rotterdam]
2 NUS - National University of Singapore
3 Department of Clinical Neurophysiology, Canisius-Wilhelmina Hospital, Nijmegen

Background: In Guillain-Barré 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 form of GBS 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 diarrhea and positive C. jejuni serology. Electrophysiological characteristics in C. jejuni-related cases were compared with those in GBS patients with viral infections. In addition, eight GBS patients with positive stool cultures for C. jejuni were analysed. Results: Seventeen (14%) of 123 patients had a C. jejuni-related GBS. Nine (53%) of these patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the strict criteria for the demyelinating form of GBS. In addition, two (25%) of eight additional patients with a C. jejuni-positive stool sample had a demyelination form of GBS. Conclusion: In the Netherlands, infections with C. jejuni do not exclusively elicit the AMAN variant of GBS, even when C. jejuni infections are defined by strict clinical and serological criteria.

Mots clés: CAMPYLOBACTER; EMG; GUILLAIN-BARRE SYNDROME; NEUROIMMUNOLOGY; NEUROPHYSIOL; CLINICAL

Judith Drenthen, Nobuhiro Yuki, Jan Meulstee, Ellen M Maathuis, Pieter A Doorn Van, et al.. Guillain-Barré syndrome subtypes related to Campylobacter infection. Journal of Neurology, Neurosurgery and Psychiatry, 2011, 82 (3), pp.300. ⟨10.1136/jnnp.2010.226639⟩. ⟨hal-00611250⟩