title: [Guillain-Barré polyneuropathy in Wegener's granulomatosis with pulmonary-renal syndrome].
abstract: A 49-year-old female patient suffering from severe necrotising respiratory granulomatosis (Wegener's granulomatosis) had acute renal failure, nearly uncontrollable haemoptyses and severe deterioration of pulmonary function. Haemodialysis had to be performed; immuno-suppressive therapy was effected by administration of high doses of methylprednisolone (100-500 mg/d) and cyclophosphamide (initially with single doses of 500-1000 mg) and plasmaphereses. Artificial ventilation by positive-negative pressure breathing became necessary because pulmonary function became consistently poorer. Glucocorticoid therapy led to the development of several duodenal ulcers resulting in profuse gastrointestinal bleedings requiring transfusions; on the whole, 20 erythrocyte concentrates had to be substituted. These transfusions, in turn, caused a non-A, non-B hepatitis. In the further course of the illness, a Guillain-Barré polyneuropathy developed. Biopsy and electrophysiological tests excluded granulomatous involvement of the nerves as a cause of the latter. But it is likely that there was a pathogenetic connection between the hepatitis and the polyneuropathy.
authors.affiliation: Medizinische Klinik und Neurologische Klinik, Universität Heidelberg.
authors.forename: F
authors.initials: F
authors.lastname: Gutzler
authors.forename: K
authors.initials: K
authors.lastname: Andrassy
authors.forename: B
authors.initials: B
authors.lastname: Kommerell
authors.forename: D
authors.initials: D
authors.lastname: Krieger
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000628:therapy; D001706:Biopsy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000139:chemically induced; D004576:Electromyography; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000628:therapy; D006469:Hemoptysis / Q000150:complications* / Q000628:therapy; D006526:Hepatitis C / Q000150:complications / Q000209:etiology; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D010956:Plasmapheresis; D011129:Polyradiculoneuropathy / Q000209:etiology*; D006435:Renal Dialysis; D012131:Respiratory Insufficiency / Q000150:complications* / Q000628:therapy; D013497:Sural Nerve / Q000473:pathology; D013577:Syndrome; D065227:Transfusion Reaction
chemical_list: D003520:Cyclophosphamide; D008775:Methylprednisolone
vernacular_title: Guillain-Barré-Polyneuropathie bei Wegenerscher Granulomatose mit pulmorenalem Syndrom.