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Guillain-Barré sendromunda mevsimsel özellikler ve klinik alt tiplerin 63 vakalık seride değerlendirilmesi

Year 2018, Volume: 10 Issue: 3, 284 - 288, 30.09.2018
https://doi.org/10.21601/ortadogutipdergisi.332864

Abstract

Amaç: Guillain–Barré sendromu (GBS)
akut yada subakut başlayabilen genellikle ilerleyici flask paralizi ile
seyreden inflamatuar demyelinizan poliradikülonöropatiler içerisinde yer alan
bir hastalıktır. Bu çalışmanın amacı kendi hasta grubumuzda GBS'nin mevsimlere
göre dağılımını, mevsimle  GBS alt
tipleri arasındaki  ilişkiyi ve mevsimle
prognoz arasındaki ilişkiyi  araştırmaktır.

Gereç ve Yöntem: Bu çalışmada 2007-2017 yılları arasında kliniğimizde
yatarak tedavi görmüş Asbury tanı kriterlerine göre kesin GBS tanısı almış
erişkin hastaların dosyaları
retrospektif olarak  tarandı.Hastaların
 yaş, cinsiyet, geçirilmiş enfeksiyonlar, mevsimlere göre dağılımı, klinik
alt tipleri , hastanede kalış süreleri, Hughes Fonksiyonel Ölçeği Skoru (HFÖS),
yoğun bakım ihtiyaçları, entübasyon , 
mortalite durumları kaydedildi.

Bulgular:
Çalışmaya 63 hasta alındı. Hastaların 35'i erkek, 28'i kadındı.  Yaş ortalaması erkeklerde
51,4±18,2,
kadınlarda
47,07±18,9
idi. AIDP hastaların
37
(%58,7)
'sinde,  AMAN
hastaların
8 (%12,7)'inde,
AMSAN hastaların
6 (%9,5)'sında,
Miller-Fisher Sendromu hastaların
5
(%7,9)
'inde görüldü. GBS semptomları başlamadan önceki 2-4 haftada
hastaların
30 (%47,6)'unda
ÜSYE, 
15 (%2,8)'inde GİS enfeksiyonu, 1 (%1,6)'inde
aşı öyküsü vardı. Mevsimsel dağılıma bakıldığında hastaların
13(%20,6)'ü
kış mevsiminde,
21 (%33,3)'i
ilkbaharda,
19 (%30,2)'u
yaz mevsiminde,
10 (%15,9)'u
sonbaharda idi. Mevsimsel dağılım ile klinik alt tipler arasındaki ilişkiye
bakıldığında AIDP formunda mevsimsel fark saptanmazken aksonal formlar ilkbahar
ve yaz mevsiminde diğer mevsimlere göre daha sık ortaya çıkmıştır. Hastaneye
ilk başvuru HFÖS ile mevsimsel dağılıma bakıldığında en düşük HFÖS ilkbaharda
saptandı.







Sonuç:
Çalışmamızda, GBS hastalarında aksonal form, ilkbahar ve yaz
mevsiminde daha sıktı. Buna ek olarak, ilkbaharda görülenler vakalarda prognoz
daha iyi iken kış aylarında daha kötüdür. Hastaların mevsimsel dağılımları
arasındaki ilişkinin daha fazla sayıda hasta ile değerlendirilmesi gerektiğini
düşünüyoruz.

References

  • KAYNAKLAR: 1-Hou H.Q, Miao J, Feng X.D, Han M, Song X.J, Guo L. Changes in lymphocyte subsets in patients with Guillain-Barré syndrome treated with immunoglobulin. BMC Neurol. 2014; 14: 202.
  • 2-.Bhargava A., Banakar B.F, Pujar G.S, Khichar S. A study of Guillain–Barré syndrome with reference to cranial neuropathy and its prognostic implication J Neurosci Rural Pract. 2014 Nov; 5(Suppl 1): S43–S47.
  • 3-Nyati K.K. Prasad K.N.Role of Cytokines and Toll-Like Receptors in the Immunopathogenesis of Guillain-Barré Syndrome Mediators of Inflammation.Volume 2014, Article ID 758639, 10 pages http://dx.doi.org/10.1155/2014/758639
  • 4- González-Suárez I, Sanz-Gallego I, Rodríguez de Rivera F.J. Arpa J. Guillain-Barré Syndrome: Natural history and prognostic factors: a retrospective review of 106 cases
  • 5- Gazioglu S. Tomak T. Boz C. Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences . 2013, Vol. 30 Issue 1, p124-134. 11p.
  • 6- Wallıng A.D, Dıckson G,. Guillain-Barré Syndrome .Am Fam Physi¬cian. 2013;87(3):191-197.
  • 7- Hughes RAC, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneuropathy. Lancet 1978; 2 (8093):750-3.
  • 8- Kleyweg RP, van der Meche FG, Schmitz PI. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barre syndrome. Muscle Nerve 1991;14:1103-9.)
  • 9-Sudulagunta S.R, Sodalagunta M.B, Sepehrar M. Khorram H, Raja S.K.B, Kothandapani S. Noroozpour Z. Sham M.A, Prasad N. Sunny S.P, Mohammed M.D, Gangadharappa M, SudarshanR.N.Guillain-Barre Sydrome: clinical profile and management Ger Med Sci. 2015; 13: Doc16. doi: 10.3205/000220
  • 10-Suryapranata F.S.T, Ang C.W, Chong L.L, Murk J.L, Falconi J, Ralph M.H.G. Huits Epidemiology of Guillain–Barré Syndrome in Aruba. Am. J. Trop. Med. Hyg., 94(6), 2016, pp. 1380–1384
  • 11-Sharma A, Lal V, Modi M, Vaishnavi C, Prabhakar S.Campylobacter jejuni infection in Guillain-Barré syndrome: A prospective case control study in a tertiary care hospital. Neurology India 59 (5),2011: 717-721
  • 12-Webb A.J.S, Brain S.A.E, Wood R, Rinaldi S, Turner M.R. Seasonal variation in Guillain-Barré syndrome: a systematic review, meta-analysis and Oxfordshire cohort study. J Neurol Neurosurg Psychiatry 2015;86:1196–1201. doi:10.1136/jnnp-2014-309056
  • 13-Sriganesh K, Netto A, Kulkarni G.B, Taly A.B, Rao G.S.U. Seasonal variation in the clinical recovery of patients with Guillain Barré syndrome requiring mechanical ventilation. Neurol. India 2013.61:(4) 349-354.

Seasonal characteristics and clinical treatment in the Guillaine-Barré syndrome 63 evaluation of the patient series

Year 2018, Volume: 10 Issue: 3, 284 - 288, 30.09.2018
https://doi.org/10.21601/ortadogutipdergisi.332864

Abstract

Background: Guillain-Barré
syndrome (GBS) is a disease that occurs with in the inflammatory demyelinating polyradiculoneuropathies
of the common flaccid paralysis that can begin in the acute or subacute stage. The aim of this study was to investigate the relationship
between seasonal distribution of GBS in our own patient group, the relationship
between seasonal GBS subtypes and seasonal prognosis.

Material and Method: This study retrospectively reviewed the files of
adult patients who were diagnosed as GBS-diagnosed according to Asbury diagnostic
criteria in our clinic between 2007 and 2017. Age, sex, past infections,
seasonal distribution, clinical subtypes, hospitalization times, Hughes Functional
Scale HFRS), intensive care needs, intubation, and mortality were recorded.

Results: Sixty-three patients were included in the study. The
patients were 35 males and 28 females. The mean age was 51.4 ± 18.2 in males and
47.07 ± 18.9 in females. In 37 (58.7%) of AIDP patients, 8 (12.7%) in AMAN
patients, 6 (9.5%) in AMSAN patients and 5 (7.9%) in Miller-Fisher syndrome patients
were found to be indent. Before the onset of GBS symptoms, there were 30
(47.6%) Upper respiratory tract infection patients, 15 (23.8%) indent GIS
infections, and 1 (1.6%) indent vaccination history at 2-4 weeks. When the seasonal
distribution was examined, 13 (20.6%) of the patients were in the winter, 21
(33.3%) were in the spring, 19 (30.2%) were in the summer and 10 (15.9%) were
in the autumn. Given the relationship between seasonal distribution and clinical
subtypes, no seasonal difference was found in AIDP form, where asaxonal forms appeared
more frequently in spring and summer than in other seasons. When the first application
to the hospital and the seasonal distribution with HFRS were taken, the lowest
HFRS was determined in the spring.







Conclusion: In
our study, axonal form in GBS patients was more frequent in spring and summer seasons.
In addition, those who are seen in the spring are better be haved and the treatment
is worse in the winter months while the treatment is better. We think that the relationship
between seasonal distributions of patients should be evaluated with higher number
of studies.

References

  • KAYNAKLAR: 1-Hou H.Q, Miao J, Feng X.D, Han M, Song X.J, Guo L. Changes in lymphocyte subsets in patients with Guillain-Barré syndrome treated with immunoglobulin. BMC Neurol. 2014; 14: 202.
  • 2-.Bhargava A., Banakar B.F, Pujar G.S, Khichar S. A study of Guillain–Barré syndrome with reference to cranial neuropathy and its prognostic implication J Neurosci Rural Pract. 2014 Nov; 5(Suppl 1): S43–S47.
  • 3-Nyati K.K. Prasad K.N.Role of Cytokines and Toll-Like Receptors in the Immunopathogenesis of Guillain-Barré Syndrome Mediators of Inflammation.Volume 2014, Article ID 758639, 10 pages http://dx.doi.org/10.1155/2014/758639
  • 4- González-Suárez I, Sanz-Gallego I, Rodríguez de Rivera F.J. Arpa J. Guillain-Barré Syndrome: Natural history and prognostic factors: a retrospective review of 106 cases
  • 5- Gazioglu S. Tomak T. Boz C. Guillain Barre Sendromunda Klinik Özellikler ve Prognoz. Journal of Neurological Sciences . 2013, Vol. 30 Issue 1, p124-134. 11p.
  • 6- Wallıng A.D, Dıckson G,. Guillain-Barré Syndrome .Am Fam Physi¬cian. 2013;87(3):191-197.
  • 7- Hughes RAC, Newsom-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneuropathy. Lancet 1978; 2 (8093):750-3.
  • 8- Kleyweg RP, van der Meche FG, Schmitz PI. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barre syndrome. Muscle Nerve 1991;14:1103-9.)
  • 9-Sudulagunta S.R, Sodalagunta M.B, Sepehrar M. Khorram H, Raja S.K.B, Kothandapani S. Noroozpour Z. Sham M.A, Prasad N. Sunny S.P, Mohammed M.D, Gangadharappa M, SudarshanR.N.Guillain-Barre Sydrome: clinical profile and management Ger Med Sci. 2015; 13: Doc16. doi: 10.3205/000220
  • 10-Suryapranata F.S.T, Ang C.W, Chong L.L, Murk J.L, Falconi J, Ralph M.H.G. Huits Epidemiology of Guillain–Barré Syndrome in Aruba. Am. J. Trop. Med. Hyg., 94(6), 2016, pp. 1380–1384
  • 11-Sharma A, Lal V, Modi M, Vaishnavi C, Prabhakar S.Campylobacter jejuni infection in Guillain-Barré syndrome: A prospective case control study in a tertiary care hospital. Neurology India 59 (5),2011: 717-721
  • 12-Webb A.J.S, Brain S.A.E, Wood R, Rinaldi S, Turner M.R. Seasonal variation in Guillain-Barré syndrome: a systematic review, meta-analysis and Oxfordshire cohort study. J Neurol Neurosurg Psychiatry 2015;86:1196–1201. doi:10.1136/jnnp-2014-309056
  • 13-Sriganesh K, Netto A, Kulkarni G.B, Taly A.B, Rao G.S.U. Seasonal variation in the clinical recovery of patients with Guillain Barré syndrome requiring mechanical ventilation. Neurol. India 2013.61:(4) 349-354.
There are 13 citations in total.

Details

Subjects Health Care Administration
Journal Section Original article
Authors

Yeşim Güzey Aras

Belma Doğan Güngen

Publication Date September 30, 2018
Published in Issue Year 2018 Volume: 10 Issue: 3

Cite

Vancouver Güzey Aras Y, Doğan Güngen B. Guillain-Barré sendromunda mevsimsel özellikler ve klinik alt tiplerin 63 vakalık seride değerlendirilmesi. omj. 2018;10(3):284-8.

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