Leonhard, Sonja E. and van der Eijk, Annemiek A. and Andersen, Henning and Antonini, Giovanni and Arends, Samuel and Attarian, Shahram and Barroso, Fabio A. and Bateman, Kathleen J. and Batstra, Manou R. and Benedetti, Luana and van den Berg, Bianca and Van den Bergh, Peter and Burmann, Jan and Busby, Mark and Casasnovas, Carlos and Cornblath, David R. and Davidson, Amy and Doets, Alex Y. and van Doorn, Pieter A. and de la Cour, Charlotte Dornonville and Feasby, Thomas E. and Fehmi, Janev and Garcia-Sobrino, Tania and Goldstein, Jonathan M. and Gorson, Kenneth C. and Granit, Volkan and Hadden, Robert D. M. and Harbo, Thomas and Hartung, Hans-Peter and Hasan, Imran and Holbech, Jakob and Holt, James K. L. and Jahan, Israt and Islam, Zhahirul and Karafiath, Summer and Katzberg, Hans D. and Kleyweg, Ruud P. and Kolb, Noah and Kuitwaard, Krista and Kuwahara, Motoi and Kusunoki, Susumu and Luijten, Linda W. G. and Kuwabara, Satoshi and Pan, Edward Lee and Lehmann, Helmar C. and Maas, Marijke and Martin-Aguilar, Lorena and Al Miller, James and Mohammad, Quazi Deen and Monges, Soledad and Nedkova-Hristova, Velina and Nobile-Orazio, Eduardo and Pardo, Julio and Pereon, Yann and Querol, Luis and Reisin, Ricardo and Van Rijs, Wouter and Rinaldi, Simon and Roberts, Rhys C. and Roodbol, Joyce and Shahrizaila, Nortina and Sindrup, Soren Hein and Stein, Beth and Cheng-Yin, Tan and Tankisi, Hatice and Tio-Gillen, Anne P. and Tous, Maria J. Sedano and Verboon, Christine and Vermeij, Frederique H. and Visser, Leo H. and Huizinga, Ruth and Willison, Hugh J. and Jacobs, Bart C. and Consortium, IGOS (2022) An international perspective on preceding infections in guillain-barre syndrome the IGOS-1000 cohort. Neurology, 99 (12). E1299-E1313. ISSN 0028-3878, DOI https://doi.org/10.1212/WNL.0000000000200885.
Full text not available from this repository.Abstract
Background and Objectives Infections play a key role in the development of Guillain-Barre syndrome (GBS) and have been associated with specific clinical features and disease severity. The clinical variation of GBS across geographical regions has been suggested to be related to differences in the distribution of preceding infections, but this has not been studied on a large scale. Methods We analyzed the first 1,000 patients included in the International GBS Outcome Study with available biosamples (n = 768) for the presence of a recent infection with Campylobacter jejuni, hepatitis E virus, Mycoplasma pneumoniae, cytomegalovirus, and Epstein-Barr virus. Results Serologic evidence of a recent infection with C. jejuni was found in 228 (30%), M. pneumoniae in 77 (10%), hepatitis E virus in 23 (3%), cytomegalovirus in 30 (4%), and Epstein-Barr virus in 7 (1%) patients. Evidence of more than 1 recent infection was found in 49 (6%) of these patients. Symptoms of antecedent infections were reported in 556 patients (72%), and this proportion did not significantly differ between those testing positive or negative for a recent infection. The proportions of infections were similar across continents. The sensorimotor variant and the demyelinating electrophysiologic subtype were most frequent across all infection groups, although proportions were significantly higher in patients with a cytomegalovirus and significantly lower in those with a C. jejuni infection. C. jejuni-positive patients were more severely affected, indicated by a lower Medical Research Council sum score at nadir (p = 0.004) and a longer time to regain the ability to walk independently (p = 0.005). The pure motor variant and axonal electrophysiologic subtype were more frequent in Asian compared with American or European C. jejuni-positive patients (p < 0.001, resp. p = 0.001). Time to nadir was longer in the cytomegalovirus-positive patients (p = 0.004). Discussion Across geographical regions, the distribution of infections was similar, but the association between infection and clinical phenotype differed. A mismatch between symptom reporting and serologic results and the high frequency of coinfections demonstrate the importance of broad serologic testing in identifying the most likely infectious trigger. The association between infections and outcome indicates their value for future prognostic models.
| Item Type: | Article |
|---|---|
| Funders: | Annexon Biosciences, Annexon Biosciences, Hansa Biopharma |
| Uncontrolled Keywords: | Immunoglobulin |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 05 Aug 2025 08:27 |
| Last Modified: | 05 Aug 2025 08:27 |
| URI: | http://eprints.um.edu.my/id/eprint/41090 |
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