Ginanneschi Federica, Giannini Fabio, Sicurelli Francesco, Battisti Carla, Capoccitti Giorgio, Bartalini Sabina, Mignarri Andrea, Volpi Nila, Cioncoloni David, Franci Laura, De Stefano Nicola, Rossi Alessandro
Neurology and Clinical Neurophysiology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
Clinical Neurology and Neurometabolic Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
Front Neurol. 2022 Jun 29;13:856091. doi: 10.3389/fneur.2022.856091. eCollection 2022.
Clinical presentation, electrophysiological subtype, and outcome of the Guillain-Barre' Syndrome (GBS) may differ between patients from different geographical regions. This study aims to assess clinical-neurophysiological features of an adult, Italian GBS cohort over 11 years.
Retrospective (from 1 January 2011 to 31 December 2021) analysis was carried out on patients admitted to the Siena University Hospital who fulfilled the GBS diagnostic criteria. Demographic data, clinical characteristics, treatment, need of mechanical ventilation (MV), laboratory and electrophysiological tests, preceding infections/vaccination/other conditions, and comorbidities were collected for each patient.
A total of 84 patients (51 men, median age of 61 years), were identified. GBS subtype was classified as acute inflammatory demyelinating polyneuropathy (AIDP) in the 66.6% of patients, acute motor/sensory axonal neuropathy (AMAN/AMSAN) in 20.2%, and the Miller Fisher syndrome in 5 (5.9%). Flu syndrome and gastrointestinal infection were the most common preceding conditions. In total, five (5.9%) subjects had concomitant cytomegalovirus (CMV) infection. Cranial nerve involvement occurred in 34.5% of subjects. Differences between the axonal and AIDP forms of GBS concerned the presence of anti-ganglioside antibodies. In total, seven (8.33%) patients required MV.
The epidemiological and clinical characteristics of GBS in different countries are constantly evolving, especially in relation to environmental changes. This study provides updated clinical-epidemiological information in an Italian cohort.
不同地理区域的吉兰-巴雷综合征（GBS）患者的临床表现、电生理亚型和预后可能有所不同。本研究旨在评估一个意大利成年GBS队列11年来的临床神经生理学特征。
对锡耶纳大学医院收治的符合GBS诊断标准的患者进行回顾性分析（从2011年1月1日至2021年12月31日）。收集每位患者的人口统计学数据、临床特征、治疗情况、机械通气需求、实验室和电生理检查结果、前驱感染/疫苗接种/其他情况以及合并症。
共确定了84例患者（51名男性，中位年龄61岁）。GBS亚型分类为：66.6%的患者为急性炎症性脱髓鞘性多发性神经病（AIDP），20.2%为急性运动/感觉轴索性神经病（AMAN/AMSAN），5例（5.9%）为米勒-费雪综合征。流感样综合征和胃肠道感染是最常见的前驱情况。共有5名（5.9%）受试者合并巨细胞病毒（CMV）感染。34.5%的受试者出现颅神经受累。GBS的轴索性和AIDP形式之间的差异与抗神经节苷脂抗体的存在有关。共有7例（8.33%）患者需要机械通气。
不同国家GBS的流行病学和临床特征在不断演变，特别是与环境变化有关。本研究提供了一个意大利队列的最新临床流行病学信息。
