medigraphic.com
ISSN 1405-1699 (Impreso)
Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2010, Número 2

Alerg Asma Inmunol Pediatr 2010; 19 (2)


Síndrome de Guillain-Barré

Mendoza-Hernández D, Blancas GL, Gutiérrez HJA

Idioma: Español
Referencias bibliográficas: 54
Paginas: 56-63
Archivo PDF: 246.75 Kb.


RESUMEN

El síndrome de Guillain-Barré es la principal causa de parálisis fl ácida aguda, con una incidencia mundial del 0.6 a 2.4 casos por 100,000 habitantes, con una relación de 1.5:1 hombre/mujer. Se considera un proceso infl amatorio de los nervios periféricos con afección principal de la mielina. La hipótesis principal respecto a su etiología considera la presencia de autoanticuerpos dirigidos contra antígenos del sistema nervioso periférico posterior a la presencia de un proceso infeccioso bacterianoo viral como consecuencia de un mimetismo molecular y reactividad cruzada entre los antígenos bacterianos y los epítopes neuronales con la estimulación de células T y la producción de anticuerpo. El tratamiento con gammaglobulina o plasmaférisis han demostrado una efi cacia similar, sin embargo se prefi ere la administración de gammaglobulina intravenosa en pacientes pediátricos por su seguridad. Sólo el 40% de los pacientes reciben rehabilitación incluyendo atención en la fase aguda y el 20% presentará discapacidad signifi cativa. Se estima una mortalidad cercana al 15%. La siguiente revisión presenta los mecanismos autoinmunes, el cuadro clínico y los diferentes patrones de afección neuronal así como los diferentes tratamientos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Agrawal S, Peake D, Whitehouse WP. Management of children with Guillain-Barre syndrome. Arch Dis Child Educ Pract Ed 2007; 92(6): 161-8.

  2. Jones HR Jr. Guillain-Barre syndrome: perspectives with infants and children. Semin Pediatr Neurol 2000; 7(2): 91-102.

  3. Beghi E et al. Guillain-Barre syndrome. Clinicoepidemiologic features and effect of infl uenza vaccine. Arch Neurol 1985; 42(11): 1053-7.

  4. Rantala H, Uhari M, Niemela M. Occurrence, clinical manifestations, and prognosis of Guillain-Barre syndrome. Arch Dis Child 1991; 66(6): 706-8; discussion 708-9.

  5. Olive JM et al. Epidemiologic study of Guillain-Barre syndrome in children < 15 years of age in Latin America. J Infect Dis 1997; 175 Suppl 1: S160-4.

  6. Yuki N et al. Carbohydrate mimicry between human ganglioside GM1 and Campylobacter jejuni lipooligosaccharide causes Guillain-Barre syndrome. Proc Natl Acad Sci U S A 2004; 101(31): 11404-9.

  7. Hughes RA, Cornblath DR. Guillain-Barre syndrome. Lancet2005; 366(9497): 1653-66.

  8. Schessl J et al. Infections and vaccinations preceding childhood Guillain-Barre syndrome: a prospective study. Eur J Pediatr 2006; 165(9): 605-12.

  9. Kuroki S et al. Campylobacter jejuni strains from patients with Guillain-Barre syndrome belong mostly to Penner serogroup 19 and contain beta-N-acetylglucosamine residues. Ann Neurol 1993; 33(3): 243-7.

  10. Rees JH et al. Campylobacter jejuni infection and Guillain- Barre syndrome. N Engl J Med 1995; 333(21): 1374-9.

  11. McCarthy N, Giesecke J. Incidence of Guillain-Barre syndrome following infection with Campylobacter jejuni. Am J Epidemiol 2001; 153(6): 610-4.

  12. Sheikh KA et al. Molecular mimicry in Guillain-Barre syndrome. Ann N Y Acad Sci 1998; 845: 307-21.

  13. Chiba A et al. Serum anti-GQ1b IgG antibody is associated with ophthalmoplegia in Miller Fisher syndrome and Guillain- Barre syndrome: clinical and immunohistochemical studies. Neurology 1993; 43(10): 1911-7.

  14. von Wulffen H, Hartard C, Scharein E. Seroreactivity to Campylobacter jejuni and gangliosides in patients with Guillain- Barre syndrome. J Infect Dis 1994; 170(4): 828-33.

  15. Hao Q et al. Anti-GalNAc-GD1a antibody-associated Guillain- Barre syndrome with a predominantly distal weakness without cranial nerve impairment and sensory disturbance. Ann Neurol 1999; 45(6): 758-68.

  16. Chiba A et al. Ganglioside composition of the human cranial nerves, with special reference to pathophysiology of Miller Fisher syndrome. Brain Res 1997; 745(1-2): 32-6.

  17. Ropper AH. The Guillain-Barre syndrome. N Engl J Med 1992; 326(17): 1130-6.

  18. Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 1990; 27 Suppl: S21-4.

  19. Evans OB, Vedanarayanan V. Guillain-Barre syndrome. Pediatr Rev 1997; 18(1): 10-6.

  20. Jones HR. Childhood Guillain-Barre syndrome: clinical presentation, diagnosis, and therapy. J Child Neurol 1996; 11(1): 4-12.

  21. Korinthenberg R, Schessl J, Kirschner J. Clinical presentation and course of childhood Guillain-Barre syndrome: a prospective multicentre study. Neuropediatrics 2007; 38(1): 10-7.

  22. Nguyen DK, Agenarioti-Belanger S, Vanasse M. Pain and the Guillain-Barre syndrome in children under 6 years old. J Pediatr 1999; 134(6): 773-6.

  23. Epstein MA, Sladky JT. The role of plasmapheresis in childhood Guillain-Barre syndrome. Ann Neurol 1990; 28(1): 65-9.

  24. Kleyweg RP et al. The natural history of the Guillain-Barre syndrome in 18 children and 50 adults. J Neurol Neurosurg Psychiatry 1989; 52(7): 853-6.

  25. Cole GF, Matthew DJ. Prognosis in severe Guillain-Barre syndrome. Arch Dis Child 1987; 62(3): 288-91.

  26. Briscoe DM, McMenamin JB, O’Donohoe NV. Prognosis in Guillain-Barre syndrome. Arch Dis Child 1987; 62(7): 733-5.

  27. Visser LH et al. Guillain-Barre syndrome without sensory loss (acute motor neuropathy). A subgroup with specifi c clinical, electrodiagnostic and laboratory features. Dutch Guillain-Barre Study Group. Brain 1995; 118(Pt 4): 841-7.

  28. Nachamkin I et al. Patterns of Guillain-Barre syndrome in children: results from a Mexican population. Neurology 2007; 69(17): 1665-71.

  29. Ho TW et al. Motor nerve terminal degeneration provides a potential mechanism for rapid recovery in acute motor axonal neuropathy after Campylobacter infection. Neurology 1997; 48(3): 717-24.

  30. Feasby TE et al. Severe axonal degeneration in acute Guillain- Barre syndrome: evidence of two different mechanisms? J Neurol Sci 1993; 116(2): 185-92.

  31. Marks HG, Augustyn P, Allen RJ. Fisher’s syndrome in children. Pediatrics 1977; 60(5): 726-9.

  32. Visser LH et al. Cytomegalovirus infection and Guillain-Barre syndrome: the clinical, electrophysiologic, and prognostic features. Dutch Guillain-Barre Study Group. Neurology 1996; 47(3): 668-73.

  33. Polo JM et al. [Atypical Guillain-Barre syndrome: multiple cranial neuropathy]. Rev Neurol 2002; 34(9): 835-7.

  34. Ropper AH, Wijdicks EF, Shahani BT. Electrodiagnostic abnormalities in 113 consecutive patients with Guillain-Barre syndrome. Arch Neurol 1990; 47(8): 881-7.

  35. McKhann GM et al. Clinical and electrophysiological aspects of acute paralytic disease of children and young adults in northern China. Lancet 1991; 338(8767): 593-7.

  36. Bernsen RA et al. Residual physical outcome and daily living 3 to 6 years after Guillain-Barre syndrome. Neurology 1999; 53(2): 409-10.

  37. Fletcher DD et al. Long-term outcome in patients with Guillain- Barre syndrome requiring mechanical ventilation. Neurology 2000; 54(12): 2311-5.

  38. Meythaler JM. Rehabilitation of Guillain-Barre syndrome. Arch Phys Med Rehabil 1997; 78(8): 872-9.

  39. Hughes RA et al. Supportive care for patients with Guillain- Barre syndrome. Arch Neurol 2005; 62(8): 1194-8.

  40. Lawn ND et al. Anticipating mechanical ventilation in Guillain- Barre syndrome. Arch Neurol 2001; 58(6): 893-8.

  41. Hund EF et al. Intensive management and treatment of severe Guillain-Barre syndrome. Crit Care Med 1993; 21(3): 433-46.

  42. Kanra G et al. Intravenous immunoglobulin treatment in children with Guillain-Barre syndrome. Eur J Paediatr Neurol 1997; 1(1): 7-12.

  43. Yata J et al. High-dose immunoglobulin therapy for Guillain- Barre syndrome in Japanese children. Pediatr Int 2003; 45(5): 543-9.

  44. Reisin RC et al. Severe Guillain-Barre syndrome in childhood treated with human immune globulin. Pediatr Neurol 1996; 14(4): 308-12.

  45. Teeling JL et al. Therapeutic effi cacy of intravenous immunoglobulin preparations depends on the immunoglobulin G dimers: studies in experimental immune thrombocytopenia. Blood 2001; 98(4): 1095-9.

  46. Kessel A et al. Intravenous immunoglobulin therapy affects T regulatory cells by increasing their suppressive function. J Immunol 2007; 179(8): 5571-5.

  47. Kuitwaard K et al. Pharmacokinetics of intravenous immunoglobulin and outcome in Guillain-Barre syndrome. Ann Neurol 2009; 66(5): 597-603.

  48. Korinthenberg R et al. Intravenously administered immunoglobulin in the treatment of childhood Guillain-Barre syndrome: a randomized trial. Pediatrics 2005; 116(1): 8-14.

  49. Graf WD et al. Outcome in severe pediatric Guillain-Barre syndrome after immunotherapy or supportive care. Neurology 1999; 52(7): 1494-7.

  50. Singhi SC et al. Intravenous immunoglobulin in very severe childhood Guillain-Barre syndrome. Ann Trop Paediatr 1999; 19(2): 167-74.

  51. Irani DN et al. Relapse in Guillain-Barre syndrome after treatment with human immune globulin. Neurology 1993; 43(5): 872-5.

  52. Koul R et al. Ten-year prospective study (clinical spectrum) of childhood Guillain-Barre syndrome in the Arabian peninsula: comparison of outcome in patients in the pre- and post-intravenous immunoglobulin eras. J Child Neurol 2003; 18(11): 767-71.

  53. Nyland H et al. Plasma exchange in patients with Guillain- Barre syndrome: clinical improvement in patients with serum IgG antibodies to peripheral nerve tissue. Int J Artif Organs 1984; 7(3): 133-6.

  54. Raphael JC et al. Plasma exchange for Guillain-Barre syndrome. Cochrane Database Syst Rev 2002; (2): CD001798.




2020     |     www.medigraphic.com