title: Guillain-Barré syndrome associated with Japanese encephalitis virus infection in China.
abstract: Abstract Guillain-Barré syndrome (GBS) is preceded by an infection in about two-thirds of patients. However, the infectious organism is often not identified. GBS secondary to Japanese encephalitis virus (JEV) infection has been reported only in India. Herein, we report a case of GBS preceded by JEV infection in China. A 23-year-old male had generalized weakness, numbness in the extremities, and bilateral facial nerve paralysis. One week prior, he had a high fever with headache, and several days later, he developed facial diplegia and sensory disturbances. Physical examination revealed facial diplegia and a weak gag reflex, quadriparesis more pronounced distally, generalized hyporeflexia, and no Babinski sign. JEV IgM and hepatitis B surface antibody (HbsAb) tests were positive. Other tests for hepatitis B infection were negative. Nerve electrophysiology suggested an acute demyelinating sensorimotor polyradiculoneuropathy. His cerebrospinal fluid was clear, the leukocyte count was 5 × 10(6)/L (normal range: 0-5 × 10(6)/L), protein 0.62 g/L (normal range: 0.15-0.45 g/L), and JEV IgM was weakly positive. He was diagnosed with GBS associated with a recent JEV infection. Intravenous (IV) immunoglobulins combined with IV methylprednisone was administered for 5 days, and at the 3-month follow-up, a complete neurological recovery was noted. GBS may be associated with JEV infection. GBS exhibits a good response to intravenous immunoglobulin or plasma exchange and has a good prognosis making prompt diagnosis important.
authors.affiliation: 1 Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai, China .
authors.forename: Jing-Yan
authors.initials: JY
authors.lastname: Xiang
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Zhang
authors.forename: Zhi-Rong
authors.initials: ZR
authors.lastname: Tan
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.forename: Yu-Wu
authors.initials: YW
authors.lastname: Zhao
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000097:blood; D002681:China; D018349:Encephalitis Viruses, Japanese / Q000276:immunology; D004672:Encephalitis, Japanese / Q000150:complications*; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000473:pathology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D008775:Methylprednisolone