PP-120 Dysentery with Campylobacter jejuni preceeding to Guillain-Barré syndrome

• Published in: BMJ paediatrics open Vol. 8; no. Suppl 5; p. A115
• Main Authors: Akbas, Merve, Ucar, Mircan, Dogan, Aysenur, Isik, Fatih, Mertoglu, Sevinc, Kafadar, Ihsan
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.07.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Acute motor axonal neuropathy; Campylobacter; Campylobacter jejuni; Cerebrospinal fluid; Dysentery; Emergency medical care; Guillain-Barre syndrome; Guillain-Barré Syndrome; Magnetic resonance imaging; Pediatrics; Poster Presentation
• ISSN: 2399-9772
• DOI: 10.1136/bmjpo-2024-EPAC.264

AimIn this study, a case of a 6 years old boy admitting to the emergency department with weakness, pain in both legs and a sudden loss of ability to walk with a history of dysentery occuring from time to time during the last 10 months and detection of Campylobacter jejuni in his fecal sample.Material and MethodA 6 years old boy with a medical history of dysentery came to the emergency unit with weakness and pain in both legs for the last two days which was worsening. On examination, deep tendon reflexes on both upper extremities were intact but patellar and achilles tendon reflexes were absent. Muscle strength of both upper extremities was 5/5 but of lower extremities was 3/5. There was not any sensory loss. He then hospitalized with the diagnosis of GBS and treatment with intravenous immunoglobulins was initiated.ResultsThe clinical diagnosis was confirmed by cerebrospinal fluid analysis, nerve conduction studies and magnetic resonance imaging MRI) of the spine. In the MRI there was contrast substance accumulation in fillum terminale (figure 1). In the cerebrospinal fluid there was albuminocytologic dissociation. The last time the patient had dysentery was a month ago. In the fecal sample Campylobacter jejuni was detected by Real Time PCR. A rare condition of GBS with its most common cause was seen. In the electromyography there were findings compatible with the Acute motor axonal neuropathy (AMAN) type of GBS.Abstract PP-120 Figure 1Fillum terminale. In the MRI there was contrast substance accumulation in fillum terminale.ConclusionsGBS is an acute immune-mediated peripheral neuropathy which is characterized by acute areflectic paralysis with albuminocytologic dissociation and it is considered a neurological emergency. It’s annual incidence in children is reported to be 0,6 per 100000 per year. About a quarter of patients with GBS have had a recent Campylobacter jejuni infection and axonal forms of the disease are especially common in these patients.