RESUMO
A group of 13 children, aged 2 to 14 years, and diagnosed with Guillain-Barré syndrome has been analyzed. Clinical features and outcome were retrospectively studied. In 75% of the patients there was an infectious illness previous to the neurologic symptoms and in four children the etiologic agent was demonstrated. Motor deficits affecting the limbs and muscle stretch reflexes were absent in all thirteen patients. Cranial nerve involvement showed-up in 46%. Meningitic symptoms occurred in 62% of the cases. One of the children developed the Fisher syndrome variant. Two patients required assisted ventilation. Three children showed associated immunologic abnormalities, with one of the patients having a selective IgA deficiency, another child showing an increment in IgE and the other Kawasaki syndrome. We have not demonstrated differences in the outcome between the patients with corticoid treatment.
Assuntos
Polirradiculoneuropatia/imunologia , Adolescente , Criança , Pré-Escolar , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/imunologia , Doenças Desmielinizantes/complicações , Eletroencefalografia , Eletromiografia , Feminino , Humanos , Imunoglobulina M/imunologia , Masculino , Transtornos dos Movimentos/complicações , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/imunologia , Polirradiculoneuropatia/complicações , Polirradiculoneuropatia/terapia , Reflexo de Estiramento , Respiração Artificial , Estudos Retrospectivos , Fatores SexuaisRESUMO
Ten patients with hemolytic uremic syndrome (HUS) were admitted to our ICU during the last 7 years. The mean age at entry was 26 month old. Only one child was more than 2 years of age. A greater incidence of this illness was noted during the summer season. Almost all cases (90%), were severe with arterial hypertension and requiring peritoneal dialysis. HUS is a multisystemic disorder with early renal involvement, but the possibility of other sites being affected must be kept in mind. Half of the patients presented extrarenal manifestations of disease, including: seizures (30%), colonic ischemia requiring intestinal resection, and heart failure with lung edema due to severe hypertension. The two parameters that were helpful in determining the prognosis were the interval of renal insufficiency (greater than 14 days) and neurologic impairment, with the later being of most importance.
