Clinical and laboratory findings in scrub typhus associated Guillain-Barré syndrome in South Korea

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Journal of the Peripheral Nervous System Pub Date : 2024-01-29 DOI:10.1111/jns.12614
Byeol-A Yoon, Sun-Young Kim, Juhyeon Kim, Jung Im Seok, Jin Myoung Seok, Sukyoon Lee, Jong Kuk Kim, Seong-il Oh
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Abstract

Background and Aims

Scrub typhus is an endemic disease in the fall season that occurs in a limited number of places known as the Tsutsugamushi Triangle. Peripheral neuropathy is a common complication of scrub typhus. Herein, we encountered several patients with ascending paralysis after scrub typhus infection, who were diagnosed with Guillain-Barré syndrome (GBS). We aimed to investigate the clinical and laboratory characteristics of patients who developed GBS after scrub typhus.

Methods

Patients were retrospectively recruited from six nationwide tertiary centers in South Korea from January 2017 to December 2021. Patients who had been clinically diagnosed with GBS and confirmed to have scrub typhus via laboratory examination and/or the presence of an eschar before the onset of acute limb paralysis were included. The GBS-associated clinical and electrophysiological characteristics, outcomes, and scrub typhus-associated features were collected.

Results

Of the seven enrolled patients, six were female and one was male. The median time from scrub typhus infection to the onset of limb weakness was 6 (range: 2–14) days. All patients had eschar on their bodies. Four patients (57.1%) were admitted to the intensive care unit and received artificial ventilation for respiratory distress. At 6 months, the median GBS disability score was 2 (range, 1–4) points.

Interpretation

Patients with scrub typhus-associated GBS have a severe clinical presentation and require intensive treatment with additional immunotherapies. Therefore, GBS should be included in the differential diagnosis when peripheral neuropathies develop during scrub typhus treatment. Notably, scrub typhus is associated to GBS.

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韩国恙虫病相关格林-巴利综合征的临床和实验室研究结果。
背景和目的:恙虫病是一种秋季流行病,仅在少数几个地方发生,这些地方被称为恙虫病三角区(Tsutsugamushi Triangle)。周围神经病变是恙虫病的常见并发症。在这里,我们遇到了几名感染恙虫病后出现上升性麻痹的患者,他们被诊断为吉兰-巴雷综合征(GBS)。我们的目的是调查恙虫病后发生吉兰-巴雷综合征的患者的临床和实验室特征:2017年1月至2021年12月期间,我们从韩国的6个全国性三级中心回顾性地招募了患者。纳入的患者均在急性肢体麻痹发病前经临床诊断为GBS,并通过实验室检查和/或出现焦痂证实患有恙虫病。研究人员收集了与GBS相关的临床和电生理特征、结果以及恙虫病相关特征:结果:七名入组患者中,六名为女性,一名为男性。从感染恙虫病到出现肢体无力的中位时间为6天(范围:2-14天)。所有患者身上都有焦痂。四名患者(57.1%)因呼吸困难被送入重症监护室并接受人工呼吸。6个月后,GBS残疾评分的中位数为2分(范围:1-4分):恙虫病相关 GBS 患者临床表现严重,需要使用额外的免疫疗法进行强化治疗。因此,在治疗恙虫病期间出现周围神经病时,应将 GBS 纳入鉴别诊断。值得注意的是,恙虫病与 GBS 相关。
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来源期刊
CiteScore
6.10
自引率
7.90%
发文量
45
审稿时长
>12 weeks
期刊介绍: The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.
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