Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands.
Department of Neurology and Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
J Neurol Sci. 2021 Jan 15;420:117272. doi: 10.1016/j.jns.2020.117272. Epub 2020 Dec 14.
To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil.
We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids.
Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently.
A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS.
确定寨卡病毒（ZIKV）感染后吉兰-巴雷综合征（GBS）的临床表型、抗神经节苷脂抗体特征以及其他循环虫媒病毒的作用，我们描述了在巴西东北部 ZIKV 和基孔肯雅病毒（CHIKV）暴发期间确定的一组 GBS 患者。
我们在 2014 年 12 月至 2017 年 2 月期间，在巴西东北部的一个区域神经病学中心前瞻性招募 GBS 患者。通过 RT-PCR 和抗体检测血清和 CSF 中的 ZIKV、CHIKV 和登革热病毒（DENV），并检测血清中与 GBS 相关的神经节苷脂抗体。
共确定了 71 例患者。48 例（68%）有近期虫媒病毒感染的实验室证据；25 例（52%）为 ZIKV、8 例（17%）为 CHIKV、1 例（2%）为 DENV 和 14 例（29%）为 ZIKV 和 CHIKV。大多数近期有虫媒病毒感染的患者有运动和感觉症状（72%）、脱髓鞘电生理亚型（67%）和面瘫（58%）。与其他患者相比，近期感染 ZIKV 和 CHIKV 的患者住院时间更长，更频繁地需要机械通气。尽管 GM1、GalC、LM1 和 GalNAc-GD1a 的抗体滴度较低，但未发现与 arbovirus 感染相关的特定抗神经节苷脂抗体特征。
很大一部分病例有近期 ZIKV 或 CHIKV 感染的实验室证据，近三分之一的患者近期同时感染了这两种病毒。大多数近期 arbovirus 感染的患者均为感觉运动性、脱髓鞘性 GBS。我们未发现与 arbovirus 相关 GBS 相关的特定抗神经节苷脂抗体特征。
