Sindrome de Guillain-Barre variante axonal en pediatria: reporte de caso / Guillain-Barre Syndrome axonal variant in pediatrics: case report

RESUMEN El síndrome de Guillain-Barré es una polirradiculoneuropatía inflamatoria aguda, caracterizada por debilidad simétrica de carácter progresivo, de inicio distal asociado con arreflexia y síntomas sensitivos leves. La variante NMAA es una entidad poco frecuente en América Latina. Se reporta el caso de un paciente de sexo masculino, de seis años, previamente sano, con diagnóstico de síndrome de Guillain-Barré variante axonal, secundario a cuadro de vías aéreas superiores. La importancia del reporte radica en informar al pediatra y a otros profesionales de la salud acerca de la existencia de esta entidad y así aumentar la sospecha diagnóstica, considerando su baja incidencia. Se destaca también la posibilidad de encontrar variabilidad en las formas clínicas típicas de presentación, como lo fue el caso presentado, ya que es un subtipo de la enfermedad que está clásicamente caracterizada como grave, de evolución tórpida y con frecuentes secuelas.

SUMMARY Guillain-Barre syndrome is an acute inflammatory polyradiculoneuropathy characterized by progressive symmetric weakness of distal onset associated with areflexia and mild sensory symptoms. The AMAN variant is a rare entity in Latin America. The case of a 6-year-old male patient, previously healthy, with a diagnosis of Guillain-Barre Syndrome, axonal variant, secondary to upper airway symptoms, is reported. The importance of the report lies in informing the pediatrician and other health professionals about the existence of this entity and thus increasing the diagnostic suspicion considering its low incidence. We also highlight the possibility of finding variability in the typical clinical forms of presentation, as was the case presented, since it is a subtype of the disease that is classically characterized as severe and with torpid evolution. It is also associated with frequent sequelae.

Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children / 소아과

PURPOSE: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.