title: Characteristics of patients with Guillain Barre Syndrome at a tertiary care centre in Pakistan, 1995-2003.
abstract: OBJECTIVE
  To study the clinical presentation, hospital course and outcome of patients admitted with Guillain Barre Syndrome (GBS) to a tertiary care hospital in Karachi, Pakistan.
  
  
  METHODS
  The charts of patients conforming to International Classification of Diseases (ICD) code 9.0, for GBS, from September 1995 to January 2003 were reviewed. Clinical data was recorded on a standardized questionnaire, which included patients' age, sex, antecedent events, neurological signs and symptoms and ventilation requirement. The hospital course was analyzed, including nosocomial infections, therapy given and the functional status of patients, using the Rankin scale (0-6). Standard SPSS 11.5 software (Windows) was used for data analysis.
  
  
  RESULTS
  Thirty-four cases of GBS were admitted to the hospital during the study period, with an age range of 3 to 70 years. The mean age for disease onset was 35.2 years for female patients, compared to 30 years for males; the male/female ratio was 1.6:1.Gastrointestinal infections (12/22, 54.6%) were the most common antecedent event, followed by upper respiratory tract infections (9/22, 40.9%) and skin lesions (1/22, 4.5%). Most patients developed GBS within one month of the preceding infection. Cranial nerve abnormalities (30/34, 88.2%), autonomic dysfunction (21/34, 61.8%) and respiratory failure requiring intubation (19/34, 55.9%) were also common. The median Rankin score of patients at admission, and at 30 and 60 days thereafter was 5, 4 and 3.5 respectively. The in-patient mortality was 1 of 34 (2.4%).
  
  
  CONCLUSIONS
  We found that GBS occurred at all ages and was slightly more common in males. Majority of patients had an antecedent history of infection and had severe disease on presentation. The patients were treated with either plasmapheresis or intravenous immunoglobulins and there was no significant difference in outcome in the two groups. Despite severe persistent disability, in-hospital mortality was low.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Mohammad Yawar
authors.initials: MY
authors.lastname: Yakoob
authors.forename: Aisha
authors.initials: A
authors.lastname: Rahman
authors.forename: Bushra
authors.initials: B
authors.lastname: Jamil
authors.forename: Nadir Ali
authors.initials: NA
authors.lastname: Syed
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010154:Pakistan; D010956:Plasmapheresis; D012141:Respiratory Tract Infections / Q000150:complications; D011795:Surveys and Questionnaires
chemical_list: D007136:Immunoglobulins