title: Bladder dysfunction and hypertension in children with Guillain-Barre syndrome.
abstract: BACKGROUND
  Guillain-Barre syndrome (GBS) causes acute motor, sensory and autonomic dysfunction. There is a relative paucity of published data regarding the autonomic features of GBS. The aims of this study were to describe the incidence, management and outcome of bladder dysfunction and hypertension in GBS and to ascertain whether these features relate to muscle weakness severity.
  
  
  METHODS
  Twenty-seven patients with a median (interquartile range) age of 5.7 (3.5-8.4) years were included, of whom 18 (67%) were male and 14 (52%) had autonomic dysfunction. One patient presented with and three subsequently developed urinary retention necessitating catheterisation for a median of 7.5 (7-14.5) days. Univariate analysis demonstrated that urinary retention was associated with weakness in all four limbs [retention: MRC muscle grade 2 (2-2.75); no retention: MRC grade 4 (3-4); p = 0.02], possibly reflecting more severe disease. Patients with hypertension (12 patients, 44%) had a longer hospital stay [median 32.5 (15.5-53.5) days; rho = 0.65; p = 0.02], and those with worse muscle weakness required more anti-hypertensive medications (upper limb rho = -0.71, p = 0.03; lower limb rho = -0.72, p = 0.03]. The majority of blood pressure treatments involved calcium channel and beta blockers.
  
  
  CONCLUSIONS
  In children with GBS, bladder dysfunction and hypertension are common. The presence of severe muscle weakness may predict those at greatest risk of these complications.
authors.affiliation: Department of Paediatric Nephrology, Royal Manchester Children's Hospital and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK, louise.watson@liv.ac.uk.
authors.forename: Louise
authors.initials: L
authors.lastname: Watson
authors.forename: Majid
authors.initials: M
authors.lastname: Aziz
authors.forename: Grace
authors.initials: G
authors.lastname: Vassallo
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Plant
authors.forename: Nicholas J A
authors.initials: NJ
authors.lastname: Webb
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D018908:Muscle Weakness / Q000453:epidemiology / Q000209:etiology; D001743:Urinary Bladder / Q000503:physiopathology; D016055:Urinary Retention / Q000453:epidemiology / Q000209:etiology*