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隐孢子虫病——吉兰-巴雷综合征复发的一个可能原因。

Cryptosporidiosis - A Plausible Cause for Relapse of Guillain-Barré Syndrome.

作者信息

Khan Asadullah Anees, Somasundaram Karthik

机构信息

Intensive Care Unit, St. Peter's Hospital, Ashford and St. Peter's Hospitals NHS Trust, Chertsey, GBR.

出版信息

Cureus. 2021 Apr 23;13(4):e14652. doi: 10.7759/cureus.14652.

Abstract

A 25-year-old female presented on the acute medical take with rapidly evolving ascending weakness, sensory loss, and areflexia after a prodromal diarrhoeal illness, ultimately critical care admission, tracheostomy, and intravenous immunoglobulin (IVIG) therapy. The patient had been diagnosed with Guillain-Barré Syndrome (GBS) six years previously, treated with intravenous Immunoglobulin, and discharged after a five-day in-patient stay without mechanical ventilation. On this occasion, a diagnosis of recurrent GBS was made, supported by cytoalbuminological dissociation in the cerebrospinal fluid (CSF). Investigations for infective precipitants were negative aside from a stool culture, positive for . DNA (deoxyribonucleic acid) two weeks earlier. There are no previously reported cases of GBS due to cryptosporidiosis on PubMed. The patient was treated with a course of IVIG and discharged from critical care after 66 days, requiring ongoing neurorehabilitation, which is likely to be prolonged.

摘要

一名25岁女性因前驱性腹泻病后迅速进展的上行性肌无力、感觉丧失和腱反射消失,在急性内科就诊,最终入住重症监护病房,接受气管切开术和静脉注射免疫球蛋白(IVIG)治疗。该患者6年前被诊断为吉兰-巴雷综合征(GBS),接受静脉注射免疫球蛋白治疗,住院5天后未行机械通气即出院。此次,脑脊液(CSF)出现蛋白细胞分离,支持复发性GBS的诊断。除粪便培养外,感染性诱因的检查均为阴性,两周前粪便培养隐孢子虫DNA呈阳性。在PubMed上此前没有隐孢子虫病导致GBS的报道病例。该患者接受了一个疗程的IVIG治疗,66天后从重症监护病房出院,需要持续的神经康复治疗,且康复过程可能会延长。

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本文引用的文献

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IVIG treatment and prognosis in Guillain-Barré syndrome.静脉注射免疫球蛋白治疗吉兰-巴雷综合征及预后。
J Clin Immunol. 2010 May;30 Suppl 1(Suppl 1):S74-8. doi: 10.1007/s10875-010-9407-4.

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