Guillain-Barré syndrome associated with cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation.
The association between cytomegalovirus (CMV) infection and the development of Guillain-Barré syndrome (GBS) in the setting of allogeneic hematopoietic stem cell transplantation (alloSCT) has been reported only occasionally. We describe here a 23-year-old patient diagnosed with acute myelogenous leukemia who underwent a partially HLA-mismatched alloSCT and soon after developed GBS along with a CMV infection. Serum autoantibodies to several ganglioside antigens were concomitantly detected. Despite therapy with ganciclovir and plasma exchanges, the patient's clinical condition rapidly deteriorated, and he died 3 weeks later with persisting CMV antigenemia. Although a coincidental association cannot be excluded, it could be speculated that a pathogenetic link exists between the 2 disorders. In this sense, molecular mimicry between viral antigens and neural host tissues could be postulated as the hypothetical mechanism underlying the triggering of the autoimmune disease in the present case.
Hernández-Boluda
J-C
JC
Hematology and Medical Oncology Service, Hospital Clínico Universitario, Valencia, Spain. hernandez.jca@gva.es
Lis
M-J
MJ
Goterris
R
R
Arbona
C
C
Terol
M-J
MJ
Tormo
M
M
Solano
C
C
D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications*; D020275:Guillain-Barre Syndrome / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D014184:Transplantation, Homologous / Q000009:adverse effects*