Abdelmogheth Anas-Alwogud, El-Baroudy Islam, Al-Yaaruby Saif
Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2013 Feb;13(1):147-51. Epub 2013 Feb 27.
Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that can cause total motor paralysis in severe cases. Reports of hypercalcaemia in patients with GBS are rare. Plasmapheresis, an extracorporeal blood purification procedure for the removal of large molecular weight substances, is a well-established therapy for ventilated GBS patients. Although it has been observed in a few reported cases, theoretically, hypercalcaemia is not described as a plasmapheresis-related problem unless there is an underlying cause. We present a rare case of an 8-year-old child presenting with headache, diplopia, and squint, followed by disturbed conscious levels and paralysis. He was treated with both intravenous immunoglobulin and plasmapheresis, with a favourable outcome. We made a laboratory observation of hypercalcaemia which was associated with the plasmapheresis therapy without any related underlying cause. This raises the need for similar observations and the gathering of other possible acceptable explanations.
吉兰-巴雷综合征(GBS)是一种急性炎症性多发性神经根神经病,严重时可导致完全性运动麻痹。GBS患者出现高钙血症的报道较为罕见。血浆置换是一种用于清除大分子物质的体外血液净化程序,是治疗需要通气的GBS患者的一种成熟疗法。虽然在少数报道的病例中观察到了这种情况,但从理论上讲,除非存在潜在病因,高钙血症并不被描述为与血浆置换相关的问题。我们报告一例罕见病例,一名8岁儿童出现头痛、复视和斜视,随后意识水平紊乱和瘫痪。他接受了静脉注射免疫球蛋白和血浆置换治疗,结果良好。我们在实验室观察到与血浆置换治疗相关的高钙血症,且无任何相关潜在病因。这就需要进行类似的观察并收集其他可能合理的解释。