Division of Critical Care Medicine, Nara Prefecture General Medical Center, Japan.
Department of Neurology, Nara Prefecture General Medical Center, Japan.
Intern Med. 2023 Oct 15;62(20):3037-3041. doi: 10.2169/internalmedicine.1094-22. Epub 2023 Mar 1.
Guillain-Barré syndrome (GBS) cases are generally monophasic, and recurrence is rare. However, the pathogenesis and pathophysiology of recurrent GBS remain to be fully elucidated. There are few detailed reports of patients who have been infected twice with Campylobacter jejuni and have developed GBS twice. We herein report a case of recurrent GBS in a 21-year-old man with a history of GBS caused by C. jejuni infection at 19 years old. Although our patient was reinfected with C. jejuni, several different anti-ganglioside antibodies were identified, and the clinical manifestations were more severe than those in the first GBS episode. We compared the anti-ganglioside antibodies and nerve conduction studies findings between the two GBS episodes. This case suggested that different antibodies are involved and produce different symptoms even when C. jejuni infection is the trigger in recurrent episodes.
格林-巴利综合征(GBS)一般为单相病程,复发罕见。然而,复发性 GBS 的发病机制和病理生理学仍未完全阐明。关于两次感染空肠弯曲菌并发生两次 GBS 的患者的详细报告较少。我们在此报告一例 21 岁男性复发性 GBS 病例,该患者 19 岁时曾因空肠弯曲菌感染发生 GBS。尽管我们的患者再次感染空肠弯曲菌,但鉴定出了几种不同的抗神经节苷脂抗体,且临床表现比首次 GBS 发作更为严重。我们比较了两次 GBS 发作时的抗神经节苷脂抗体和神经传导研究结果。该病例提示,即使空肠弯曲菌感染是复发的诱因,不同的抗体也可能参与其中,并产生不同的症状。