Campylobacter infection as a trigger for Guillain-Barré syndrome in Egypt.
BACKGROUND
Most studies of Campylobacter infection triggering Guillain-Barré Syndrome (GBS) are conducted in western nations were Campylobacter infection and immunity is relatively rare. In this study, we explored Campylobacter infections, Campylobacter serotypes, autoantibodies to gangliosides, and GBS in Egypt, a country where Campylobacter exposure is common.


METHODS
GBS cases (n = 133) were compared to age- and hospital-matched patient controls (n = 374). A nerve conduction study was performed on cases and a clinical history, serum sample, and stool specimen obtained for all subjects.


RESULTS
Most (63.3%) cases were demyelinating type; median age four years. Cases were more likely than controls to have diarrhea (29.5% vs. 22.5%, Adjusted Odds Ratio (ORa) = 1.69, P = 0.03), to have higher geometric mean IgM anti-Campylobacter antibody titers (8.18 vs. 7.25 P<0.001), and to produce antiganglioside antibodies (e.g., anti-Gd1a, 35.3 vs. 11.5, ORa = 4.39, P<0.0001). Of 26 Penner:Lior Campylobacter serotypes isolated, only one (41:27, C. jejuni, P = 0.02) was associated with GBS.


CONCLUSIONS
Unlike results from western nations, data suggested that GBS cases were primarily in the young and cases and many controls had a history of infection to a variety of Campylobacter serotypes. Still, the higher rates of diarrhea and greater antibody production against Campylobacter and gangliosides in GBS patients were consistent with findings from western countries.
Wierzba
Thomas F
TF
US Naval Medical Research Unit No 3, Cairo, Egypt. Director@NAMRU2.org.kh
Abdel-Messih
Ibrahim Adib
IA
Gharib
Bayoumi
B
Baqar
Shahida
S
Hendaui
Amina
A
Khalil
Ibrahim
I
Omar
Tarek A
TA
Khayat
Hamed E
HE
Putnam
Shannon D
SD
Sanders
John W
JW
Ng
Lai-King
LK
Price
Lawrence J
LJ
Scott
Daniel A
DA
Frenck
Robert R
RR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002169:Campylobacter Infections / Q000150:complications* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005732:Gangliosides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000209:etiology / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D055815:Young Adult
D005732:Gangliosides