AI Article Synopsis
- Guillain-Barre syndrome (GBS) can have relapses despite often being a one-time illness; a 55-year-old woman experienced an initial recovery from GBS after immunoglobulin treatment but relapsed shortly after due to treatment-related fluctuation (TRF).
- TRF involves temporary improvement followed by a setback in GBS symptoms within two months of the illness beginning, which happened in this case despite excluding other potential diagnoses like recurrent GBS.
- Factors such as other health issues, significant muscle weakness, and a lack of prior diarrhea indicated a higher risk for TRF, in addition to the role of early treatment and ongoing immune responses affecting recovery.
Article Abstract
Guillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159355 | PMC |
| http://dx.doi.org/10.4103/0976-3147.83585 | DOI Listing |
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