Clinical severity and associated complications in pediatric patients with Guillain-Barré syndrome

• Published in: Revista mexicana de neurociencia Vol. 21; no. 1; pp. 15 - 26
• Main Authors: Solana-Rojas, Ángel, García-Melo, Luis M., Reyes-Varela, María D., Díaz-Sotelo, Juan F., Cruz-Sánchez, Alfredo, Pérez-Moreno, Juan C., Basulto-López, Francisco E., Salinas-Oviedo, Carolina
• Format: Journal Article
• Language: English; Portuguese
• Published: Academia Mexicana de Neurología A.C 07.02.2020
• Subjects: Clinical Neurology; Neurosciences; Pediatrics; Guillain Barre en pediatría; Mechanic Ventilation; Guillain Barre; Severidad clínica; Ventilación mecánica
• ISSN: 2604-6180
• DOI: 10.24875/RMN.19000014

Abstract Background: Guillain-Barré syndrome (GBS) is an acute demyelinating polyradiculoneuropathy, of autoimmune origin, with heterogeneous clinical variants. It is the most frequent cause of flaccid paralysis in children. Incidence of 0.38-0.91 cases per 100,000, rare in children under 2 years. Objective: The objective of the study was to describe the clinical severity and complications in pediatric patients aged 1-18 years with GBS. Methods: A descriptive and retrospective analysis was carried out. We collected data from clinical files of patients of Legaria Pediatric Hospital with stellate ganglion block, period of 3 years (January 2015-December 2017). Results: Twenty-four patients, 18 men (75%) and 6 women (25%) were included in the study. The average age of 7.33 years (range: 1-16 years). School patients were the most affected (45.8%). Nearly 62.5% had previous respiratory infection. The most frequent clinical variant was acute inflammatory demyelinating (62.5%), axonal motor syndrome (29.2%), and Miller Fisher syndrome (8.3%). Nearly 16.7% presented dysautonomies requiring mechanical ventilation. Nearly 50% presented albuminocytological dissociation. The most frequent degree of clinical severity at admission was Grade IV on the Hughes scale (54.2%). The degree of clinical severity most frequent at discharge was Grade II on the Hughes scale (33.3%). Only 41.7% of patients received treatment with intravenous immunoglobulin (IVIG) at 1 g/kg/dia for 2 days. Conclusions: By means of contingency tables, the association between degree of severity at admission and discharge of GBS with respect to treatment with IVIG was determined. There is a 3.8 times greater risk of severity in patients without receiving the ideal treatment.