Oligosymptomatic dengue infection: a potential cause of Guillain Barré syndrome.
BACKGROUND
Dengue infection may cause neurological manifestations such as encephalitis, myelitis, mononeuropathies, acute disseminated encephalomyelitis, and Guillain Barré syndrome (GBS). In endemic regions, the infection course can be oligosymptomatic making difficult the diagnosis of the neurological picture associated with dengue infection.


OBJECTIVE
To report dengue infection and GBS association, even in oligosymptomatic cases of this infection.


METHODS
During the dengue epidemic in Rio de Janeiro city we looked for GBS cases, testing IgM antibodies for dengue and dengue polymerase chain reaction (PCR) in the cerebrospinal fluid (CSF) and serum.


RESULTS
We report seven cases (46.6%), presenting dengue positive IgM in serum but with poor or without clinical symptoms of the previous infection. Two of them had also positive IgM antibodies in CSF.


CONCLUSIONS
These data show that search for dengue infection should be a routine in GBS cases living in endemic areas.
Neurology Service, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil. cnsoares@predialnet.com.br
Cristiane Nascimento
CN
Soares
Mauro
M
Cabral-Castro
Celina
C
Oliveira
Luis Claudio
LC
Faria
José Mauro
JM
Peralta
Marcos Raimundo Gomes de
MR
Freitas
Marzia
M
Puccioni-Sohler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D003715:Dengue / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D003716:Dengue Virus / Q000235:genetics / Q000276:immunology; D005260:Female; D020275:Guillain-Barre Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D007075:Immunoglobulin M; D012367:RNA, Viral