A Case of an Dilated Cardiomyopathy Combined with Guillain-Barre Syndrome

ABSTRACT

Many neuromuscular disorders involve the heart and may produce dilated or hypertrophic cardiomyopathy. Guillain-Barre Syndrome is an inflammatory polyradiculoneuropathy in which the autonomic nervous system is sometimes involved. ST-segment and T-wave abnormalities have been reported in which the autonomic nervous system is involved, and sudden death can be attributed to fatal arrhythmic or malignant hypertension, but cardiomypathy have been reported rare. 58-year-old woman who complained of pitting edema and exertional dyspnea was admitted. Dilated cardiomyopathy was diagnosed by transthoracic echocardiography. Guillain-Barre syndrome was diagnosed by clinical manifestation, EMG, and CSF tapping. T-wave inversion in electrocardiogram was noted, and left ventricular end-diastolic diameter and ejection fraction were 69.2mm and 37.5% respectively in transthoracic echocardiography. Coronary angiograms were normal and ergonovine test was negative. Plasmapheresis has been used as mainstay of treatment in patient with Guillain-Barre syndrome. She was treated with diuretics and digoxin. Motor paralysis improved gradually by plasmapheresis and left ventricular dysfunction improved after 8 months.