Raul Carrea Institute for Neurological Research, Department of Neurology, Buenos Aires, Argentina.
Raul Carrea Institute for Neurological Research, Department of Neuromuscular, Buenos Aires, Argentina.
Arq Neuropsiquiatr. 2022 May;80(5):516-522. doi: 10.1590/0004-282X-ANP-2021-0226.
A treatment-related fluctuation (TRF) in a patient with Guillain-Barré syndrome (GBS) is defined as clinical deterioration within two months of symptom onset following previous stabilization or improvements with treatment.
To investigate the clinical characteristics and factors that could increase the risk of relapse of GBS in patients with and without TRFs.
Retrospective review of medical records of patients (>18 years) with GBS evaluated between January/2006 and July/2019. Demographic and clinical characteristics, ancillary studies, treatment received, and the clinical course of patients with and without TRFs were analyzed.
Overall, 124 cases of GBS were included; seven (5.6%) presented TRFs. GBS-TRF cases were triggered more frequently by infectious mononucleosis (28.57 vs. 8.55%; p=0.01). GBS-TRF were initially treated with plasmapheresis more frequently than those without TRF (14.29 vs. 1.70%; p=0.0349). Combined treatment (71.43 vs. 4.27%; p<0.001) and corticosteroids (42.86 vs. 1.71%; p<0.001) were more commonly used in the GBS-TRF group. GBS-TRF patients presented a higher median initial disability score (4 vs. 2; p=0.01).
Patients with GBS triggered by infectious mononucleosis and a high degree of initial disability have higher chances of developing TRFs. Although patients with TRF were treated with plasmapheresis more often, the total number was too low to suggest a link between plasma exchange and TRF.
吉兰-巴雷综合征（GBS）患者的治疗相关波动（TRF）定义为症状出现后两个月内，在先前的稳定或治疗改善后出现临床恶化。
探讨有无 TRF 的 GBS 患者复发的临床特征和可能增加复发风险的因素。
回顾性分析 2006 年 1 月至 2019 年 7 月间评估的>18 岁的 GBS 患者的病历。分析有无 TRF 的患者的人口统计学和临床特征、辅助检查、治疗方法以及临床病程。
共有 124 例 GBS 患者纳入研究，其中 7 例（5.6%）存在 TRF。TRF 更常由传染性单核细胞增多症引起（28.57% vs. 8.55%；p=0.01）。TRF 患者更常接受血浆置换治疗（14.29% vs. 1.70%；p=0.0349）。联合治疗（71.43% vs. 4.27%；p<0.001）和皮质类固醇（42.86% vs. 1.71%；p<0.001）在 TRF 组中更常见。TRF 患者初始残疾评分中位数较高（4 分 vs. 2 分；p=0.01）。
由传染性单核细胞增多症引起且初始残疾程度较高的 GBS 患者发生 TRF 的几率更高。尽管 TRF 患者更常接受血浆置换治疗，但数量过少，无法提示血浆置换与 TRF 之间存在关联。
