title: Successful Management of Fulminant Guillain-Barré Syndrome and Its Complications.
abstract: A 3-year-old girl presented with muscle weakness of her limbs and trunk 6 days after developing symptoms of common cold. Two days later, she experienced respiratory arrest with a Glasgow Coma Scale score of 3, necessitating endotracheal intubation. Therefore, she was transferred to our hospital with suspected acute encephalopathy. Although no abnormalities were observed on brain and spinal magnetic resonance imaging and electroencephalography, peripheral nerve conduction velocity tests failed to evoke motor and sensory nerve action potentials. Thus, we gave a diagnosis of fulminant Guillain-Barré syndrome and initiated immunoglobulin therapy. On day 3 of admission, she developed sinus tachycardia that induced circulatory failure and oliguria, which was successfully treated with landiolol. Subsequently, we performed plasmapheresis followed by immunoglobulin and steroid pulse therapies. She was weaned off the mechanical ventilator by day 20 of admission, was ambulatory by day 44, and had completely recovered without any adverse sequelae by day 55. In conclusion, landiolol was effective for treating acute sinus tachycardia-induced circulatory failure and played a key role in saving the life of this patient.
authors.affiliation: From the Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kamei
authors.forename: Manami
authors.initials: M
authors.lastname: Akasaka
authors.forename: Nami
authors.initials: N
authors.lastname: Araya
authors.forename: Ken
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Takada
authors.forename: Hiromi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanifuji
authors.forename: Maya
authors.initials: M
authors.lastname: Asami
authors.forename: Yurie
authors.initials: Y
authors.lastname: Nasu
authors.forename: Kotaro
authors.initials: K
authors.lastname: Oyama
authors.forename: Shoichi
authors.initials: S
authors.lastname: Chida
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000628:therapy*; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D008279:Magnetic Resonance Imaging; D009025:Morpholines / Q000627:therapeutic use; D010956:Plasmapheresis / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods; D014508:Urea / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D005938:Glucocorticoids; D009025:Morpholines; C077049:landiolol; D014508:Urea