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接种疫苗后格林-巴利综合征:一例报告

Post Vaccination Guillain Barre Syndrome: A Case Report.

作者信息

Wajih Ullah Muhammad, Qaseem Aisha, Amray Afshan

机构信息

Cardiology, Mayo Clinic, Rochester, USA.

Internal Medicine, Ziauddin Medical University, Karachi, PAK.

出版信息

Cureus. 2018 Apr 20;10(4):e2511. doi: 10.7759/cureus.2511.

Abstract

Guillain-Barre syndrome is a rare but fatal autoimmune disease. The exact cause of Guillain-Barre syndrome is still unknown. The most common known etiology of Guillain-Barre syndrome is infectious disease notably caused by . A very small fraction of people can develop Guillain-Barre syndrome due to vaccines and vaccinations like a meningococcal vaccine, poliovirus vaccine, influenza vaccine, and rabies vaccine. Of all these, rabies is fatal invariably. It can be preventable if diagnosed early and post-exposure treatment is followed according to the World Health Organization guidelines. Older formulations of rabies vaccines are cultured in the neural tissues and have been found to have an increased risk of Guillain-Barre syndrome. Although less immunogenic older formulations of rabies vaccines are more commonly used in Asian and South American countries due to their cost-effective nature. There is little to no data available on the incidence of Guillain-Barre syndrome due to vaccinations in Pakistan. Most of the cases of Guillain-Barre syndrome due to vaccination are either undiagnosed or misdiagnosed. In this case report, we are presenting a case of vaccine-associated Guillain-Barre syndrome due to neural tissue anti-rabies vaccine in a young girl, who presented with lower limb weakness, inability to pass urine and abdominal pain.

摘要

格林-巴利综合征是一种罕见但致命的自身免疫性疾病。格林-巴利综合征的确切病因仍不清楚。格林-巴利综合征最常见的已知病因是传染病,尤其是由……引起的。极少数人可能因疫苗接种,如脑膜炎球菌疫苗、脊髓灰质炎病毒疫苗、流感疫苗和狂犬病疫苗而患上格林-巴利综合征。在所有这些情况中,狂犬病无一例外是致命的。如果早期诊断并按照世界卫生组织的指导方针进行暴露后治疗,它是可以预防的。旧剂型的狂犬病疫苗是在神经组织中培养的,已发现其患格林-巴利综合征的风险增加。尽管免疫原性较低,但旧剂型的狂犬病疫苗因其性价比高,在亚洲和南美国家更常用。在巴基斯坦,关于接种疫苗导致格林-巴利综合征发病率的数据几乎没有。大多数因接种疫苗导致的格林-巴利综合征病例要么未被诊断,要么被误诊。在本病例报告中,我们呈现了一名年轻女孩因接种神经组织狂犬病疫苗而患疫苗相关性格林-巴利综合征的病例,她出现了下肢无力、无法排尿和腹痛的症状。

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