title: Guillain-Barré syndrome subtypes related to Campylobacter infection.
abstract: BACKGROUND
  In Guillain-Barré syndrome (GBS), the diversity in electrophysiological subtypes is unexplained but may be determined by geographical factors and preceding infections. Acute motor axonal neuropathy (AMAN) is a frequent GBS variant in Japan and one study proposed that in Japan, Campylobacter jejuni infections exclusively elicit AMAN. In The Netherlands C jejuni is the predominant type of preceding infection yet AMAN is rare. This may indicate that not all Dutch GBS patients with C jejuni infections have AMAN.
  
  
  OBJECTIVE
  To determine if GBS patients with a preceding C jejuni infection in The Netherlands exclusively have AMAN.
  
  
  METHODS
  Retrospective analysis of preceding infections in relation to serial electrophysiology and clinical data from 123 GBS patients. C jejuni related cases were defined as having preceding diarrhoea and positive C jejuni serology. Electrophysiological characteristics in C jejuni related cases were compared with those in viral related GBS patients. In addition, eight GBS patients from another cohort with positive stool cultures for C jejuni were analysed.
  
  
  RESULTS
  17 (14%) of 123 patients had C jejuni related GBS. C jejuni patients had lower motor and higher sensory action potentials compared with viral related cases. Nine (53%) C jejuni patients had either AMAN or inexcitable nerves. However, three (18%) patients fulfilled the criteria for acute inflammatory demyelinating polyneuropathy (AIDP). Also, two (25%) of eight additional patients with a C jejuni positive stool sample had AIDP.
  
  
  CONCLUSIONS
  In The Netherlands, C jejuni infections are strongly, but not exclusively, associated with axonal GBS. Some patients with these infections fulfil current criteria for demyelination.
authors.affiliation: Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. j.drenthen@erasmusmc.nl
authors.forename: Judith
authors.initials: J
authors.lastname: Drenthen
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yuki
authors.forename: Jan
authors.initials: J
authors.lastname: Meulstee
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Maathuis
authors.forename: Pieter A
authors.initials: PA
authors.lastname: van Doorn
authors.forename: Gerhard H
authors.initials: GH
authors.lastname: Visser
authors.forename: Joleen H
authors.initials: JH
authors.lastname: Blok
authors.forename: Bart C
authors.initials: BC
authors.lastname: Jacobs
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000907:Antibodies, Bacterial / Q000276:immunology; D000914:Antibodies, Viral / Q000276:immunology; D002169:Campylobacter Infections / Q000150:complications*; D016123:Campylobacter jejuni / Q000276:immunology; D004576:Electromyography; D020031:Epstein-Barr Virus Infections / Q000150:complications; D020275:Guillain-Barre Syndrome / Q000145:classification / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D016472:Motor Neuron Disease / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology; D009046:Motor Neurons / Q000502:physiology; D009426:Netherlands; D012189:Retrospective Studies; D011984:Sensory Receptor Cells / Q000502:physiology
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral