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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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GUILLAIN-BARRÉ SYNDROME IN CHILDREN AND INFECTIOUS DISEASES

Lia Mano1, José Pedro Vieira2, Maria João Brito1

1- Pediatric Resident, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE Lisboa
2- Pediatric Neurology Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE Lisboa
3- Infectious Diseases Unit, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE Lisboa

- Reunião internacional: 10th Congress of the World Society for Pediatric Infectious Diseases (WSPID), Shenzhen, China, December 2-5, 2017.

Resumo
Background and aims: Guillain-Barré syndrome (GBS) is the most frequent cause of acute paralytic neuropathy. The exact cause of GBS is unknown, but 50-70% of cases appear after a respiratory or gastrointestinalinfection. 
Aims: To analyze the association between GBS and infectious disease. 
Methods: Observational descriptive study of children with GBS, between 2007 and 2017 in a Portuguese pediatric hospital. Demographic, clinical and laboratory parameters were studied. 
Results: We identified 30 patients, with median age of 5,3 years at admission. Ribatejo, in the center of Portugalhad the highest number of cases (23,3%). There was a previous disease in 66,7% of cases. The electromyogram identified a demyelination pattern (24),an exclusively motor axonal pattern (3) a mixed motor and sensory axonal pattern (2) and a sensory pattern (1). An etiologic agent was identified in 15/30 (50%) patients: Epstein_Barr virus (3), Cytomegalovirus (2), Borrelia (2), Influenza A-H1N1 (2) and others (Campylobacter, Mycoplasma pneumonia, Leptospira, Varicella-zoster virus, Enterovirus, Rhinovirus). A demyelinating polyneuropathy was associated with Epstein_Barr virus, cytomegalovirus, Mycoplasma pneumonia, Leptospira, Varicella-zoster and Influenza A-H1N1) (9/24), motor axonal with Campylobacter and Borrelia (2/3) sensory pattern with Cytomegalovirus (1/1) and Miller Fisher with Epstein_Barr virus (1/2). No statistically significant differences between infectious and noninfectious etiologic subgroups were found for sex (p=0.409),median age (p=0.529), geographical region (p=0.701), anti-ganglioside antibodies (p=0.602), pain(p=0.419) andaverage recovery time (87,1 vs 94,3 days; p=0.612).
Conclusions: The exact cause of GBS remains unknown. Prospective, multicentric studies are needed to compare patients with infectious etiology confirmed with the remainder, in a larger sample size.

Palavras Chave: Guillain-Barré,infectious,neuropathy