title: Pharyngeal-cervical-brachial variant of pediatric Guillain-Barré syndrome with antecedent acute hepatitis A virus infection.
abstract: Pharyngeal-cervical-brachial weakness is considered a variant of Guillain-Barré syndrome with limited oropharyngeal, neck, and upper limb muscle involvement. The authors report on a 7-year-old boy, who developed pharyngeal-cervical-brachial type of Guillain-Barré syndrome following an antecedent episode of acute hepatitis A virus infection, 2 weeks prior to admission. The presentation was characterized by acute onset dysphagia, loss of head control, and bilateral arm weakness. The diagnosis was confirmed by acute motor axonal changes in the arm and albuminocytologic dissociation of the cerebrospinal fluid. The child was treated with intravenous immunoglobulin, which resulted in gradual improvement over 3 weeks. Documented instances of this form of Guillain-Barré syndrome remain rare in the pediatric age group, with none existing following antecedent hepatitis A virus infection. The authors emphasize that acute hepatitis A virus infection be included in the triggers responsible for Guillain-Barré syndrome in children.
authors.affiliation: Department of Pediatrics, The Institute of Child Health, Kolkata, West Bengal, India. rajoothapa@yahoo.co.in
authors.forename: Rajoo
authors.initials: R
authors.lastname: Thapa
authors.forename: Biawajit
authors.initials: B
authors.lastname: Biswas
authors.forename: Debkrishna
authors.initials: D
authors.lastname: Mallick
authors.forename: Swapan
authors.initials: S
authors.lastname: Mukherjee
mesh_terms: D001132:Arm; D002648:Child; D003937:Diagnosis, Differential; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D006506:Hepatitis A / Q000150:complications*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D018908:Muscle Weakness / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D009334:Neck Muscles; D010609:Pharyngeal Muscles; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors