Serologic evidence of previous Campylobacter jejuni infection in patients with the Guillain-Barré syndrome.
OBJECTIVE
To determine if patients with the Guillain-Barré syndrome are likely to have had Campylobacter jejuni infection before onset of neurologic symptoms.


METHODS
A case-control study.


METHODS
Several university medical centers.


METHODS
Case patients met clinical criteria for the Guillain-Barré syndrome between 1983 and 1990 and had a serum sample collected and frozen within 3 weeks after onset of neurologic symptoms (n = 118). Disease controls were patients with other neurologic illnesses (n = 56); healthy controls were hospital employees or healthy family members of patients (n = 47).


METHODS
Serum IgA, IgG, and IgM antibodies to C. jejuni were determined by enzyme-linked immunosorbent assays. Assays were done in a blinded manner.


RESULTS
Optical density ratios > or = 2 in two or more immunoglobulin classes were seen in 43 (36%) of patients with the Guillain-Barré syndrome and in 10 (10%) of controls (odds ratio, 5.3; 95% CI, 2.4 to 12.5; P < 0.001). Increasing the optical density ratio or the number of immunoglobulin classes necessary to yield a positive result increased the strength of the association. The number of patients with the Guillain-Barré syndrome who had positive serologic responses was greatest from September to November (P = 0.02). Male patients were three times more likely to have serologic evidence of C. jejuni infection (P = 0.009); the proportion of patients with the syndrome who had a positive serologic response increased with age.


CONCLUSIONS
Patients with the Guillain-Barré syndrome are more likely than controls to have serologic evidence of C. jejuni infection in the weeks before onset of neurologic symptoms. Campylobacter jejuni may play a role in the initiation of the Guillain-Barré syndrome in many patients.
Mishu
B
B
Infectious Diseases Division, Vanderbilt University School of Medicine, Nashville, TN 37232.
Ilyas
A A
AA
Koski
C L
CL
Vriesendorp
F
F
Cook
S D
SD
Mithen
F A
FA
Blaser
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D002169:Campylobacter Infections / Q000150:complications* / Q000175:diagnosis; D016123:Campylobacter jejuni / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011129:Polyradiculoneuropathy / Q000382:microbiology*; D012621:Seasons; D012698:Serologic Tests
D000907:Antibodies, Bacterial