Antecedent infections in Guillain-Barre syndrome in endemic areas of arbovirus transmission: A multinational case-control study

Leonhard, Sonja E. and Tan, Cheng Yin and Eijk, Annemiek A. and Reisin, Ricardo R. and Franken, Suzanne C. and Huizinga, Ruth and Arends, Samuel and Batstra, Manou R. and Bezerra Jeronimo, Selma M. and Drenthen, Judith and Koning, Laura and Leon Cejas, Luciana and Marchesoni, Cintia and Marques Jr, Wilson and Shahrizaila, Nortina and Casas, Dardo F. and Sotelo, Andrea and Tillard, Belen and Dourado, Mario-Emilio and Jacobs, Bart C. (2021) Antecedent infections in Guillain-Barre syndrome in endemic areas of arbovirus transmission: A multinational case-control study. Journal of the Peripheral Nervous System, 26 (4). pp. 449-460. ISSN 1085-9489, DOI

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Half of the world's population is at risk of arthropod-borne virus (arbovirus) infections. Several arbovirus infections have been associated with Guillain-Barre syndrome (GBS). We investigated whether arboviruses are driving GBS beyond epidemic phases of transmission and studied the antibody response to glycolipids. The protocol of the International Guillain-Barre syndrome Outcome Study (IGOS), an observational prospective cohort study, was adapted to a case-control design. Serum samples were tested for a recent infection with Zika virus (ZIKV), dengue virus (DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein-Barr virus (EBV), cytomegalovirus (CMV), Campylobacter jejuni, and Mycoplasma pneumoniae, and for antibodies to glycolipids. Forty-nine patients were included from Brazil (63%), Argentina (14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%) patients: C jejuni (n = 15, 31%), M pneumoniae (n = 5, 10%), CHIKV (n = 2, 4%), EBV (n = 1, 2%), C jejuni and M pneumoniae (n = 2, 4%), CMV and DENV (n = 1, 2%), and C jejuni and DENV (n = 1, 2%). In 22 patients, 35 paired controls were collected. Odds ratio for recent infections did not significantly differ between cases and controls. No typical anti-ganglioside antibody binding was associated with recent arbovirus infection. We conclude that arbovirus infections occur in GBS patients outside of epidemic viral transmission, although not significantly more than in controls. Broad infection and anti-ganglioside antibody serology are important to establish the most likely pathogenic trigger in GBS patients. Larger studies are necessary to determine the association between arboviruses and GBS.

Item Type: Article
Funders: European Commission [Grant No: 734584], Stichting GBS
Uncontrolled Keywords: Anti-ganglioside antibodies; Anti-glycolipid antibodies; Chikungunya virus; Dengue virus; Guillain-Barre syndrome; Zika virus
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Depositing User: Ms Zaharah Ramly
Date Deposited: 27 May 2022 06:45
Last Modified: 27 May 2022 06:45

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