[Severe Guillain-Barré syndrome and pregnancy: two cases with rapid improvement post-partum].
BACKGROUND
Guillain-Barré syndrome can occur at any time of pregnancy with the same incidence as in the general population. Observations. We report two cases of patients who developed a progressive ascending paralysis during the second trimester of pregnancy. The worsening of the respiratory insufficiency for one of them required a transfer to an intensive care unit for artificial ventilation lasting 102 days. In the two cases, cerebrospinal fluid examination revealed albumin-cytological dissociation and repeated electrophysiological studies showed typical features of demyelinating neuropathy with conduction blocks. Biological investigations, especially CMV and Campylobacter jejuni serologies, were all negative. Intravenous immunoglobulin infusions, in one case associated with high doses of corticosteroïds, were ineffective. Rapid improvement was observed in the two patients after delivery.


CONCLUSIONS
These cases raise the question of the relationships between the Guillain-Barré syndrome and pregnancy. The occurrence of the disease, as well as the rapid recovery in post-partum, could be consecutive to a partial failure of the maternal immunological tolerance toward the fetus.
Vaduva
C
C
Service des Explorations Fonctionnelles Neurologiques, Hôpital Yves Le Foll, Saint-Brieuc.
de Seze
J
J
Volatron
A-C
AC
Stojkovic
T
T
Piechno
S
S
Husson
J
J
Vermersch
P
P
Furby
A
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D003131:Combined Modality Therapy; D018450:Disease Progression; D004351:Drug Resistance; D004576:Electromyography; D005260:Female; D005333:Fetus / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000276:immunology / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D007108:Immune Tolerance; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009431:Neural Conduction; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D011262:Pregnancy Trimester, Second; D012075:Remission, Spontaneous; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy
D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous