Kumar Basant, Agrawal Navin, Patra Soumya, Manjunath C N
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
BMJ Case Rep. 2013 Oct 7;2013:bcr2013200602. doi: 10.1136/bcr-2013-200602.
Guillain-Barré syndrome (GBS) constitutes a heterogeneous group of immune-mediated peripheral neuropathic disorders that can be triggered by a variety of antecedent events. Clinical symptoms are thought to result from streptokinase antibody-mediated damage to the local blood-nerve barrier. We report the case of a 50-year-old man with acute anterior wall myocardial infarction who developed GBS as a manifestation of autoimmune hypersensitivity reaction to the drug 17 days after thrombolytic therapy with streptokinase. The patient was treated with a 5-day course of intravenous γ globulin and his symptoms improved and there was no residual deficit. The case forms a reminder of the autoimmune complications of non-fibrin specific agents that can sometimes be catastrophic and require persistent and vigilant in-hospital and immediate postdischarge follow-up and immediate management.
吉兰-巴雷综合征（GBS）是一组异质性的免疫介导的周围神经病变，可由多种先前事件引发。临床症状被认为是由链激酶抗体介导的对局部血-神经屏障的损伤所致。我们报告一例50岁男性急性前壁心肌梗死患者，在接受链激酶溶栓治疗17天后发生GBS，这是对该药物自身免疫超敏反应的一种表现。患者接受了为期5天的静脉注射γ球蛋白治疗，症状改善，无残留缺陷。该病例提醒人们注意非纤维蛋白特异性药物的自身免疫并发症，这些并发症有时可能是灾难性的，需要在住院期间和出院后进行持续、警惕的随访及即时处理。
