title: Campylobacter infection as a trigger for Guillain-Barré syndrome in Egypt.
abstract: 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.
authors.affiliation: US Naval Medical Research Unit No 3, Cairo, Egypt. Director@NAMRU2.org.kh
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Wierzba
authors.forename: Ibrahim Adib
authors.initials: IA
authors.lastname: Abdel-Messih
authors.forename: Bayoumi
authors.initials: B
authors.lastname: Gharib
authors.forename: Shahida
authors.initials: S
authors.lastname: Baqar
authors.forename: Amina
authors.initials: A
authors.lastname: Hendaui
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Khalil
authors.forename: Tarek A
authors.initials: TA
authors.lastname: Omar
authors.forename: Hamed E
authors.initials: HE
authors.lastname: Khayat
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Putnam
authors.forename: John W
authors.initials: JW
authors.lastname: Sanders
authors.forename: Lai-King
authors.initials: LK
authors.lastname: Ng
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Price
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Scott
authors.forename: Robert R
authors.initials: RR
authors.lastname: Frenck
mesh_terms: 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
chemical_list: D005732:Gangliosides