Nafissi Shahriar, Vahabi Zahra, Sadeghi Ghahar Maryam, Amirzargar Ali Akbar, Naderi Soheil
Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Jul 13;51(6):372-6.
Guillain Barre Syndrome (GBS) is an inflammatory, usually demyelinating, polyneuropathy; clinically characterized by acute onset of symmetric progressive muscle weakness with loss of myotatic reflexes. Thirty five patients with GBS, defined clinically according to the criteria of Asbury and Cornblath, were recruited from three hospital affiliated to Tehran University of Medical Sciences.
As a control group 35 age and sex matched patients with other neurological diseases admitted to the same hospital at the same time, were included in our study. Serum samples were collected before treatment from each patient (within 4 weeks after the disease onset) and controls, and stored frozen at -80ºC until serologic assays were done. Serologic testing of pretreatment serum was performed in all patients. Positive titer of virus specific IgM antibody against cytomegalovirus (CMV) was found in 6 cases and 2 controls. 34 patients and 31 controls had high titer of anti Haemophilus influenzae IgG and one patient had serologic evidence of a recent Epstein Barr virus (EBV) infection. The mean titer of IgG antibody against Haemophilus influenzae in cases and controls was 5.21 and 2.97 respectively. Although serologic evidence of all these infections were more frequent in cases than in controls, only Haemophilus influenzae infection appeared to be significantly related to GBS (P=0.002). Eleven cases and 3 controls had high titers of IgG antibody against Haemophilus influenzae type B (titer >8). There is significant association between high titer of IgG antibody against Haemophilus influenzae and GBS (P=0.017). Our results provide further evidence that Haemophilus influenzae and probably CMV, can be associated with GBS.
吉兰-巴雷综合征（GBS）是一种炎症性、通常为脱髓鞘性的多发性神经病；临床特征为急性起病的对称性进行性肌无力伴肌伸张反射消失。根据阿斯伯里和科恩布拉思的标准临床诊断为GBS的35例患者，来自德黑兰医科大学附属的三家医院。
作为对照组，我们纳入了35例年龄和性别匹配、同时入住同一家医院的其他神经系统疾病患者。在治疗前（疾病发作后4周内）从每位患者和对照组采集血清样本，并在-80℃冷冻保存，直至进行血清学检测。对所有患者的治疗前血清进行血清学检测。6例患者和2例对照中发现针对巨细胞病毒（CMV）的病毒特异性IgM抗体滴度为阳性。34例患者和31例对照的抗流感嗜血杆菌IgG滴度较高，1例患者有近期EB病毒（EBV）感染的血清学证据。病例组和对照组中抗流感嗜血杆菌IgG抗体的平均滴度分别为5.21和2.97。尽管所有这些感染的血清学证据在病例组中比对照组中更常见，但只有流感嗜血杆菌感染似乎与GBS显著相关（P=0.002）。11例病例和3例对照的抗B型流感嗜血杆菌IgG抗体滴度较高（滴度>8）。抗流感嗜血杆菌IgG高滴度与GBS之间存在显著关联（P=0.017）。我们的结果提供了进一步的证据，表明流感嗜血杆菌以及可能的CMV可与GBS相关。
