Minamino Mai, Miyamoto Katsuichi, Kuwahara Motoi, Yoshikawa Keisuke, Koh Jinsoo, Kusunoki Susumu, Nagai Yoshitaka, Ito Hidefumi
Department of Neurology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.
Department of Neurology, Kindai University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
J Neurol. 2023 Apr;270(4):2191-2196. doi: 10.1007/s00415-023-11567-8. Epub 2023 Jan 16.
Japan has the world's largest super-aging population, and the number of elderly patients with various diseases is increasing. Herein, we reported the characteristics of super-elderly patients, aged over 80 years, with Guillain-Barré syndrome (GBS), a typical neuroimmune disease.
During the period 2019-2021, 74 patients over the age of 80 years diagnosed with GBS at Kindai university were analyzed as the super-elderly group patients. The control group comprised 74 consecutive patients aged < 79 years, under the same conditions. GBS was diagnosed using Brighton diagnostic criteria. Electrophysiology was assessed using the Ho criteria.
The mean age was 83.5 years in the super-elderly group and 51.7 years in the control group. Prior infection was recognized in 50% of cases in the super-elderly group and 77% of cases in the control group with fewer cases in the super-elderly group. The mean number of days until peak symptom presentation was longer in the super-elderly group. The percentage who required a ventilator was significantly higher among the super-elderly group than among the control group. Hughes functional grading scale was more severe in the super-elderly group. Electrophysiological examination revealed the demyelinating form was particularly common in the super-elderly group. Intravenous immunoglobulin was the most common treatment in both the groups, with no difference in efficacy.
Super-elderly onset GBS tends to be severe, therefore it is important to diagnose and treat appropriately, even in the absence of prior episodes of infection.
日本拥有世界上规模最大的超老龄化人口,患有各种疾病的老年患者数量正在增加。在此,我们报告了80岁以上患有吉兰-巴雷综合征(GBS)(一种典型的神经免疫疾病)的超老年患者的特征。
在2019年至2021年期间,对近畿大学诊断为GBS的74名80岁以上患者作为超老年组患者进行分析。对照组由74名年龄小于79岁的连续患者组成,条件相同。采用布莱顿诊断标准诊断GBS。使用霍氏标准评估电生理学。
超老年组的平均年龄为83.5岁,对照组为51.7岁。超老年组50%的病例和对照组77%的病例有前驱感染,超老年组的病例较少。超老年组出现症状高峰的平均天数更长。超老年组中需要呼吸机的比例显著高于对照组。超老年组的休斯功能分级量表更为严重。电生理检查显示脱髓鞘形式在超老年组中尤为常见。静脉注射免疫球蛋白是两组中最常见的治疗方法,疗效无差异。
超老年起病的GBS往往病情严重,因此即使没有前驱感染发作,也需要进行适当的诊断和治疗。