Pharmacy Department, Centre Hospitalier Sainte Justine, Montréal, Québec, Canada.
Ann Pharmacother. 2010 Jul-Aug;44(7-8):1330-3. doi: 10.1345/aph.1P078. Epub 2010 May 18.
To report a case of Guillain-Barré syndrome (GBS) following a dose of influenza A (H1N1) vaccine (Arepanrix).
An 11-year-old boy was admitted to the hospital after presenting with facial diplegia; abdominal, forehead, and thigh pain; and acute cervical pain. He had received the Arepanrix H1N1 subcutaneous vaccine 13 days before symptom onset. The neurologic examination also revealed a symmetric bilateral paralysis of the VIIth cranial nerve and intense pain, proximal weakness of the shoulder girdles and pelvis, and preserved deep tendon reflexes. Cerebrospinal fluid analysis revealed an albuminocytologic dissociation. Therefore, a diagnosis of atypical GBS following vaccination against HINI influenza was made.
Based on the clinical evaluation, laboratory test results, neurologic features, and the exclusion of alternative diagnoses, the Naranjo probability scale revealed a probable relationship between the clinical manifestations of GBS and the vaccine against influenza A (H1N1) received by the patient. This is the first published case for the 2009 influenza pandemic in children.
While recent studies have found inconclusive results on the association between influenza vaccine and GBS, all suspected cases should be published for further evaluation.
报告一例甲型 H1N1 流感（H1N1）疫苗（Arepanrix）接种后发生格林-巴利综合征（GBS）的病例。
一名 11 岁男孩因出现面瘫；腹痛、前额痛和大腿痛；以及急性颈痛而入院。他在症状出现前 13 天接受了 Arepanrix H1N1 皮下疫苗接种。神经系统检查还显示第七颅神经双侧对称性瘫痪和剧烈疼痛，肩部和骨盆近端无力，深腱反射保留。脑脊液分析显示蛋白细胞分离。因此，诊断为接种 H1N1 流感疫苗后的非典型 GBS。
根据临床评估、实验室检查结果、神经系统特征和排除其他诊断，Naranjo 概率量表显示 GBS 的临床表现与患者接种的甲型 H1N1 流感疫苗之间存在可能的关系。这是针对儿童 2009 年流感大流行的首例发表病例。
尽管最近的研究对流感疫苗与 GBS 之间的关联得出了不确定的结果，但所有疑似病例都应发表以供进一步评估。
