Relationship of bacterial strains to clinical syndromes of Campylobacter-associated neuropathies.
BACKGROUND
Clinical and serologic studies suggest that Guillain-Barré syndrome (GBS) and atypical GBS with preserved muscle stretch reflexes (MSRs) form a continuous spectrum as well as do Fisher syndrome (FS), FS/GBS overlap, Bickerstaff brainstem encephalitis (BBE), BBE/GBS overlap, acute ophthalmoparesis (AO), ataxic GBS, and acute oropharyngeal palsy.


OBJECTIVE
To clarify the spectrum of neurologic disorders that occur subsequent to Campylobacter jejuni enteritis.


METHODS
We recruited patients with various neurologic conditions and from whom C jejuni was isolated. Bacterial features were investigated.


RESULTS
Diagnoses for the patients from whom C jejuni was isolated were GBS (n = 90), FS (n = 22), MSR-preserved GBS (n = 10), FS/GBS (n = 6), BBE (n = 1), BBE/GBS (n = 2), AO (n = 3), ataxic GBS (n = 1), and acute oropharyngeal palsy (n = 3). Isolates from MSR-preserved GBS were similar to those of GBS in serotype (HS:19), genotype (lipo-oligosaccharide [LOS] locus class A or B, cst-II genotype [Thr51]), and GM1 or GD1a epitope expression on LOS. FS/GBS overlap, BBE, BBE/GBS overlap, AO, ataxic GBS, and acute oropharyngeal palsy isolates were similar to those of FS in serotype (HS:2 or HS:4-complex), genotype (LOS locus class A or B, cst-II genotype [Asn51]), and GQ1b epitope expression on LOS.


CONCLUSIONS
The bacterial findings support the proposal that Guillain-Barré syndrome (GBS) and muscle stretch reflex-preserved GBS comprise a continuous spectrum as well as do Fisher syndrome (FS), FS/GBS overlap, Bickerstaff brainstem encephalitis (BBE), BBE/GBS overlap, acute ophthalmoparesis, ataxic GBS, and acute oropharyngeal palsy.
Kimoto
K
K
Department of Neurology and Research Institute for Neuroimmunological Diseases, Dokkyo Medical University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
Koga
M
M
Odaka
M
M
Hirata
K
K
Takahashi
M
M
Li
J
J
Gilbert
M
M
Yuki
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood / Q000235:genetics / Q000276:immunology; D001933:Brain Stem / Q000382:microbiology / Q000503:physiopathology; D002169:Campylobacter Infections / Q000150:complications* / Q000276:immunology / Q000382:microbiology*; D016123:Campylobacter jejuni / Q000276:immunology / Q000472:pathogenicity*; D002648:Child; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D004751:Enteritis / Q000150:complications* / Q000276:immunology / Q000382:microbiology*; D018604:Epitope Mapping; D005260:Female; D020275:Guillain-Barre Syndrome / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019846:Miller Fisher Syndrome / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D012703:Serotyping; D013045:Species Specificity
D001323:Autoantibodies