Leprosy with Guillain Barre Syndrome: a new neurologic manifestation?
A 19-year-old female patient of lepromatous leprosy with Type II reaction, on multidrug therapy and prednisolone, presented with acute onset flaccid quadriparesis. The cerebrospinal fluid examination revealed albumino-cytologic dissociation. Nerve biopsy showed infiltration with lepra bacilli, features of vasculitis, and demyelination. There were no other identifiable precipitating factors for Guillain Barre Syndrome in this patient. Her condition improved without any steroid therapy. This case emphasizes the hypothesis that cell injury caused by Type II reaction can expose neural antigens and incite an autoimmune reaction in the form of Guillain Barre Syndrome.
Grover
Chander
C
Department of Dermatology and STD, Maulana Azad Medical College and Assoc. Hospitals, New Delhi, India.
Kubba
Samir
S
Nanda
Soni
S
Kumar
Vijay
V
Reddy
Belum Siva Nagi
BS
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D015440:Leprosy, Lepromatous / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010525:Peripheral Nerves / Q000473:pathology*; D011782:Quadriplegia / Q000209:etiology