[Guillain-barré syndrome associated Campylobacter jejuni serotype Penner 2: a case report].

We described a 15-year-old male who had Guillain-Barré syndrome(GBS). Nine days after watery diarrhea, the patient developed pain and weakness of foot muscles. On admission, the nerve conduction studies revealed peripheral neuropathy with axonal degeneration and demyelination. Campylobacter jejuni(C. jejuni) with serotype of Lior 4, Penner 2 was isolated from his stool culture. IgM anti-GM 1 antibody and other various anti-ganglioside antibodies were detected in his serum. After receiving plasma exchange and intravenous immunoglobulin therapy, he was able to walk without assistance. In general, C. jejuni with the serotype Penner 19 has been isolated from many GBS patients. In this patient, C. jejuni with the serotype of Penner 2 was isolated. The serotype is detected commonly in Miller Fisher syndrome.

[A case with perineuritis].

We reported a 62-year-old woman with perineuritis. She suffered from dysesthesia in the right radial wrist. One month later, dysesthesia in the left radial wrist occurred. Four months later, dysesthesia developed in both soles of the foot. On a neurologic examination, hypalgesia, hypesthesia, dysesthesia and areflexia were disclosed. Sensory disturbance was a distal dominant distribution. Serum anti-Borrelia burgdorferi antibody was not detected. Cerebrospinal fluid examination revealed normal protein content and cell numbers. Motor nerve conduction velocities were normal, but the sensory nerve conduction velocity of median nerve, ulnar nerve and sural nerve could not be elicited. Sural nerve biopsy revealed marked thickening of perineurium and infiltration of mononuclear cells in and around the perineurium. The infiltration of mononuclear cells was also observed around middle-sized epineurial artery and arterioles. Treatment with daily 40 mg of prednisolone only relieved the dysesthsia. After treatment with daily 60 mg of prednisolone the sensory disturbance was gradually improved. Sensory nerve potential could be evolved seven months later.