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Severe Guillain-Barré syndrome associated with chronic hepatitis B: A case report and literature review.与慢性乙型肝炎相关的重症吉兰-巴雷综合征:病例报告及文献复习。
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一名18岁男性青少年患恶性疟疾后出现吉兰-巴雷综合征:一例罕见病例报告及文献综述

Guillain-Barré Syndrome Following Falciparum Malaria in an 18-Year Male Adolescent: A Rare Case Report and Literature Review.

作者信息

Getahun Gobezu Assefa, Arega Gashaw, Jemal Miftah Kemal, Woldie Biruk Getachew, Gudina Esayas Kebede

机构信息

Gambella Town Primary Hospital Gambella Ethiopia.

Mekelle University, College of Health Sciences Mekelle Ethiopia.

出版信息

Clin Case Rep. 2025 Sep 22;13(9):e70932. doi: 10.1002/ccr3.70932. eCollection 2025 Sep.

DOI:10.1002/ccr3.70932
PMID:40995392
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12453965/
Abstract

Guillain-Barré Syndrome (GBS) is an immune-mediated disorder affecting the peripheral nerves and nerve roots, potentially leading to severe complications such as respiratory failure and autonomic dysfunction. It is commonly preceded by gastrointestinal or respiratory infections, with various bacterial and viral pathogens identified as potential triggers. However, GBS associated with parasitic infections, such as malaria, is a rare occurrence in the medical literature. We present the case of an 18-year-old male who developed progressive bilateral lower extremity weakness, eventually involving the upper extremities over 1 week. His symptoms were accompanied by voice changes, facial drooping, difficulty swallowing, and high-grade fever. On physical examination, he exhibited fluctuating vital signs and flaccid weakness with bulbar involvement. Cerebrospinal fluid (CSF) analysis revealed an elevated protein level of 172 mg/dL with no cells. Nerve conduction studies confirmed the acute motor and sensory axonal neuropathy (AMSAN) variant of GBS. A peripheral blood film was positive for the trophozoite stage of . The patient was managed with intravenous artesunate and supportive care. The weakness stabilized around day 14. He showed significant improvement in cranial nerve function and upper extremity strength at 1 month and was able to walk with minimal support at 2 months. This case report highlights the rare occurrence of GBS after infection, emphasizing the importance of early diagnosis to prevent serious complications. By adding to the limited existing literature, it aims to raise awareness and encourage further research on the condition and its management.

摘要

吉兰 - 巴雷综合征(GBS)是一种免疫介导的疾病,影响周围神经和神经根,可能导致严重并发症,如呼吸衰竭和自主神经功能障碍。它通常在胃肠道或呼吸道感染之前出现,已确定多种细菌和病毒病原体为潜在诱因。然而,与寄生虫感染(如疟疾)相关的GBS在医学文献中很少见。我们报告一例18岁男性病例,该患者出现进行性双侧下肢无力,最终在1周内累及上肢。他的症状伴有声音改变、面部下垂、吞咽困难和高热。体格检查发现他生命体征波动,存在弛缓性无力并累及延髓。脑脊液(CSF)分析显示蛋白水平升高至172mg/dL,无细胞。神经传导研究证实为GBS的急性运动和感觉轴索性神经病(AMSAN)变体。外周血涂片显示 滋养体期阳性。患者接受静脉注射青蒿琥酯和支持治疗。无力在第14天左右稳定下来。他在1个月时颅神经功能和上肢力量有显著改善,2个月时能够在极少支撑下行走。本病例报告强调了感染后GBS的罕见性,强调早期诊断以预防严重并发症的重要性。通过补充有限的现有文献,旨在提高认识并鼓励对该疾病及其管理进行进一步研究。