AI Article Synopsis
- The study investigates the relationship between Campylobacter jejuni infections and Guillain-Barré syndrome (GBS) subtypes in The Netherlands, noting that not all patients with these infections develop the typical acute motor axonal neuropathy (AMAN) variant.
- It conducted a retrospective analysis of 123 GBS patients to compare electrophysiological data between those with C jejuni infections and those with viral infections.
- The findings revealed that while a significant portion of C jejuni patients had characteristics of AMAN, some also met criteria for acute inflammatory demyelinating polyneuropathy (AIDP), suggesting a more complex interplay than previously thought.
Article Abstract
Background: In Guillain-Barré syndrome (GBS), the diversity in electrophysiological subtypes is unexplained but may be determined by geographical factors and preceding infections. Acute motor axonal neuropathy (AMAN) is a frequent GBS variant in Japan and one study proposed that in Japan, Campylobacter jejuni infections exclusively elicit AMAN. In The Netherlands C jejuni is the predominant type of preceding infection yet AMAN is rare. This may indicate that not all Dutch GBS patients with C jejuni infections have AMAN.
Objective: To determine if GBS patients with a preceding C jejuni infection in The Netherlands exclusively have AMAN.
Methods: Retrospective analysis of preceding infections in relation to serial electrophysiology and clinical data from 123 GBS patients. C jejuni related cases were defined as having preceding diarrhoea and positive C jejuni serology. Electrophysiological characteristics in C jejuni related cases were compared with those in viral related GBS patients. In addition, eight GBS patients from another cohort with positive stool cultures for C jejuni were analysed.
Results: 17 (14%) of 123 patients had C jejuni related GBS. C jejuni patients had lower motor and higher sensory action potentials compared with viral related cases. Nine (53%) C jejuni patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the criteria for acute inflammatory demyelinating polyneuropathy (AIDP). Also, two (25%) of eight additional patients with a C jejuni positive stool sample had AIDP.
Conclusion: In The Netherlands, C jejuni infections are strongly, but not exclusively, associated with axonal GBS. Some patients with these infections fulfil current criteria for demyelination.
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| http://dx.doi.org/10.1136/jnnp.2010.226639 | DOI Listing |
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