Guillain-Barré syndrome in immunocompromised patients: a report of three patients and review of the literature.
Both humoral and cell-mediated autoimmune mechanisms have been implicated in the pathogenesis of Guillain-Barré syndrome (GBS). Therefore, its occurrence in severely immunocompromised patients is not expected. We identified 3 severely immunocompromised patients who developed GBS. Two of the 3 patients had acquired immunodeficiency syndrome with CD4 counts of 5 and 4 cells/mm3, respectively. One post-cardiac transplant patient was taking azathioprine and cyclosporine at the time of onset of GBS. In all 3 patients, immunocompromise was induced by infectious or chemotherapeutic agents which preferentially suppress T-lymphocyte responses. All 3 had severe lymphocytopenia and incomplete recovery. We conclude that GBS can occur in patients with severe t-cell suppression. Although no conclusion regarding prognosis can be drawn from our small group of patients, their incomplete recovery is consistent with the idea that T-cells are important for recovery.
Qureshi
A I
AI
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Cook
A A
AA
Mishu
H P
HP
Krendel
D A
DA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology; D000328:Adult; D000368:Aged; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D011129:Polyradiculoneuropathy / Q000150:complications* / Q000276:immunology