Malignancy in Guillain-Barré syndrome: A twelve-year single-center study.
The relationship between Guillain-Barré syndrome (GBS) and malignancy is uncertain. We retrospectively analyzed data of 118 consecutive patients admitted with GBS from Birmingham, U.K. (2001-2012). We calculated relative cancer risk using different definitions and determined characteristics of malignancy-associated GBS. Malignancy was globally commoner in our GBS cohort compared to the general population (odds ratio: 2.08; CI: 1.06-3.71; p=0.036). However, this was unconfirmed if paraneoplastic criteria were applied. GBS patients with cancer were significantly more likely to be older (p=0.043), hyponatremic (p=0.037) and demonstrate more axonal loss (p<0.05). Cerebrospinal fluid (CSF) protein levels were lower in the malignancy group (p=0.002) and neurological improvement less likely (p=0.023). In-patient mortality was significantly higher in patients with malignancy (p<0.01). We conclude global cancer risk is higher in GBS than in the general population, although definition-dependent. Malignancy requires consideration in elderly, hyponatremic subjects with normal CSF protein, severe axonal loss, who fail to improve post-treatment.
Regional Neuromuscular Clinic, Queen Elizabeth Hospital, University Hospitals of Birmingham, Birmingham, United Kingdom.
Fu Liong
FL
Hiew
Regional Neuromuscular Clinic, Queen Elizabeth Hospital, University Hospitals of Birmingham, Birmingham, United Kingdom; School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom. Electronic address: y.rajabally@aston.ac.uk.
Yusuf A
YA
Rajabally
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D006113:United Kingdom
Axonal; Cancer; Guillain-Barré syndrome; Hyponatremia; Malignancy; Paraneoplastic