Síndrome de Guillain-Barrè após varicela: relato de caso

Arruda, Walter Oleschko; Aguiar, Luis R. C.; Sandoval, Paulo R. Miranda

doi:10.1590/S0004-282X1987000400011

Resumos

Os autores relatam caso grave de síndrome de Guillain-Barré após quadro inicial de varicela em rapaz de 13 anos. Como complicações este paciente desenvolveu quadriplegia flácida com insuficiência respiratória, hipertensão arterial, taquicardia e importante neuropatía sensitiva periférica (disestesia dolorosa). Comenta-se a relação entre quadros virais benignos e o desenvolvimento de polirradiculoneurite aguda, assim como o possível mecanismo imunopatogênico envolvendo fatores humorais e celulares.

The authors report a case of Guillain-Barrè syndrome (GBS) following a varicella infection in a 13 year-old boy. During his admission he developed respiratory insuficiency and dysautonomic events, as well as a severe sensitive peripheral neuropathy. Some aspects related to the etiology and pathogenesis of GBS are discussed.

Guillain-Barré syndrome after varicella-zoster infection: case report

Síndrome de Guillain-Barrè após varicela: relato de caso

Walter Oleschko Arruda^I; Luis R. C. Aguiar^II; Paulo R. Miranda Sandoval^III

^INeurologist - Intensive Care Unit, Hospital Cajuru, Pontifícia Universidade Católica do Paraná

^IINeurosurgeon - Intensive Care Unit, Hospital Cajuru, Pontifícia Universidade Católica do Paraná

^IIIIntensive care physician - Intensive Care Unit, Hospital Cajuru, Pontifícia Universidade Católica do Paraná

SUMMARY

The authors report a case of Guillain-Barrè syndrome (GBS) following a varicella infection in a 13 year-old boy. During his admission he developed respiratory insuficiency and dysautonomic events, as well as a severe sensitive peripheral neuropathy. Some aspects related to the etiology and pathogenesis of GBS are discussed.

RESUMO

Os autores relatam caso grave de síndrome de Guillain-Barré após quadro inicial de varicela em rapaz de 13 anos. Como complicações este paciente desenvolveu quadriplegia flácida com insuficiência respiratória, hipertensão arterial, taquicardia e importante neuropatía sensitiva periférica (disestesia dolorosa). Comenta-se a relação entre quadros virais benignos e o desenvolvimento de polirradiculoneurite aguda, assim como o possível mecanismo imunopatogênico envolvendo fatores humorais e celulares.

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1. ADAMS, D.; GIBSON, J.D.; THOMAS, P..K.; BATCHELOR, J.R.; HUGHES, R.A.C.; KENNEDY, L.; FESTENSTEIN, H. & SACHS, J. - HLA antigens in Guillain-Barré syndrome. Lancet 2:504, 1977.
2. ASBURY, A.K. - Diagnostic considerations in Guillain-Barre syndrome. Ann. Neurol. 9 (suppl.):1, 1981.
3. BALLE, J.F.; ROTE, N.S.; BLOOMER, L.C. & BRAY, P.F. - Guillain-Barré-like polyneuropathy after renal transplant: possible association with cytomegalovirus infection. Arch. Neurol. 37:784, 1980.
4. BAOICCO, F.; BONORA, G.; NEGRI, A.; PALMA, A. & ROGNONI, S. - Diplegia del facciale: descrizione di un caso post-varicelloso inquadrabile como sindrome di Guillain-Barre. Minerva ped. 35:521, 1983.
5. BERGER, J.R.; RAM AYYAR, D. & SHEREMATA, W.A. - Guillain-Barrê syndrome complicating acute hepatitis B. Arch. Neurol. 38:366, 1981.
6. CHARLES, R.H.G. - Post-varicella polyneuritis. Brit. med. J. 1:908, 1965.
7. COOK, S.D. & DOWLING, P.C. - The role ot autoantibody and immune complexes in the pathogenesis of Guillain-Barré syndrome. Ann. Neurol. 9 (suppl.):70, 1981.
8. COUCHOT, J.; PENNAFORTE, J.C.; FERRAND, B.L. & RULLIER, J. - Syndrome de Guillain-Barré au décours d'une varicelle. Nouv. Presse méd. 7:47, 1978.
9. DAVIES, J. & ROWLATT, R.J. - Transient severe hypertension and polyradiculitis after chickenpox. Brit. med. J. 2:1608, 1978.
10. DOWLING, P.C. & COOK, S.D. - Role of infection in Guillain-Barré syndrome: laboratory confirmation of herpesviruses in 41 cases. Ann. Neurol. 9 (suppl):44, 1981.
11. EATON, O.M.; STEVENS, H. & SILVER, H.M. - Respiratory failure in polyradiculoneuritis associated with infectious mononucleosis. J. amer. med. Assoc. 194:609, 1965.
12. GARVEY, P.H.; JONES, N. & WARREN, S.L. - Polyradiculoneuritis (Guillain-Barré syndrome) following the use of sulfanilamide and fever therapy. J. amer. med. Assoc. 115:1955, 1940.
13. GUERIN, J.M.; RAUX, M. & LAMOTTE, M. - Syndrome de Guillain-Barré après rougeole. Sem. Hop. Paris 57:1215, 1981.
14. GUERREIRO, C.A.M.; FACURE, N.O.; GONÇALVES JUNIOR, F.L.; SILVA, L. J.; RAMOS, M.C. & PEDRO, R.J. - Polirradiculoneurite e malária. Arq. Neuro-Psiquiat. (São Paulo) 43:214, 1985.
15. HODGES, G.R. & PERKIN, R.L. - Landry-Guillain-Barré syndrome associated with Mycoplasma pneumoniae infection. J. amer. med. Assoc. 210:2088, 1969.
16. HOLT, S.; KHAN, M.M.; CHARLES, R.G. & EPSTEIN, E.J. - Polyradiculoneuritis and Mycoplasma pneumoniae infection. Postgrad, med. J. 53:416, 1977.
17. IQBAL, A.; OGER, J.J.F. & ARNASON, G.W. - Cell-mediated immunity in idiopathic polyneuritis. Ann. Neurol. 9 (suppl.):65, 1981.
18. KOSKI, CL. - Guillain-Barré syndrome. Neurol. Clin. 2:355, 1984.
19. LAYZER, R.B. - Neuromuscular manifestations of systemic diseases. F.A. Davis Philadelphia, 1985.
20. MENKES, J.H. - Textbook of Child Neurology. Lea & Febiger, Philadelphia, 1985.
21. MENONNA, J.; GOLDSCHMIDT, B.; HAIDRI, N.; DOWLING, P. & COOK, S. - Herpes simplex virus-IgM specific antibodies in Guillain-Barré syndrome and encephalitis. Acta neurol. scand. 56:223, 1977.
22. MUSHINSKI, J.F.; TANIGUCHI, R.M. & STIEFEL, J.W. - Guillain-Barré syndrome associated with ulcero-glandular tularemia. Neurology 14:877, 1964.
23. PHILLIPS, P.E. - Guillain-Barré syndrome after measles. Brit. med. J. 4:50, 1972.
24. POLLACK, S.; BARON, E. & ENAT, R. - Guillain-Barré syndrome: association with mumps. N.Y. St. J. Med. 795, 1981.
25. RAB, S.M. & CHOUDHURY, G.M. - Landry-Guillain-Barré syndrome after chicken pox. N. Engl. J. Med. 268:200, 1963.
26. SAMANTRAY, S.K.; JOHNSON, S.C.; MATHAI, K.V. & PULIMOOD, B.M. - Landry-Guillain-Barré-Strohl syndrome: a estudy of 302 cases. Med. J. Aust. 2:84, 1977.
27. STEWART, G.J.; POLLARD, J.D.; McLEOD, J.G. & WOLNIZER, CM. - HLA antigens in the Landry Guillain-Barré syndrome and chronic relapsing polyneuritis. Ann. Neurol. 4:285, 1978.
28. TENSER, R.B. - Herpes simplex and herpes zoster. Neurol. Clin. 2:215, 1984.
29. TWOMEY, J.A. & JEFFERSON, D. - Encephalitis and polyneuritis complicating varicella zoster infection. Postgrad, med. J. 57:507, 1981.
30. WELCH, R.G. - Chicken-pox and the Guillain-Barré syndrome. Arch. Dis. Child. 37:557, 1962.
31. WELLER, T.H. - Varicella and herpes zoster: changing concepts of the natural history, control, and importance of a not-so-benign virus (two parts). N. Engl. J. Med. 309:1362, 1434, 1983.
32. ZIVIN, I. & SCHWAGER, V.A. - The Guillain-Barré syndrome as a complication of varicella. Dis. nerv. Syst. 33:742, 1972.

Datas de Publicação

Publicação nesta coleção
22 Jun 2011
Data do Fascículo
Dez 1987

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ADAMS, D.; GIBSON, J.D.; THOMAS, P..K.; BATCHELOR, J.R.; HUGHES, R.A.C.; KENNEDY, L.; FESTENSTEIN, H. & SACHS, J. - HLA antigens in Guillain-Barré syndrome. Lancet 2:504, 1977.

[2] 2. ASBURY, A.K. - Diagnostic considerations in Guillain-Barre syndrome. Ann. Neurol. 9 (suppl.):1, 1981.

[3] 3. BALLE, J.F.; ROTE, N.S.; BLOOMER, L.C. & BRAY, P.F. - Guillain-Barré-like polyneuropathy after renal transplant: possible association with cytomegalovirus infection. Arch. Neurol. 37:784, 1980.

[4] 4. BAOICCO, F.; BONORA, G.; NEGRI, A.; PALMA, A. & ROGNONI, S. - Diplegia del facciale: descrizione di un caso post-varicelloso inquadrabile como sindrome di Guillain-Barre. Minerva ped. 35:521, 1983.

[5] 5. BERGER, J.R.; RAM AYYAR, D. & SHEREMATA, W.A. - Guillain-Barrê syndrome complicating acute hepatitis B. Arch. Neurol. 38:366, 1981.

[6] 6. CHARLES, R.H.G. - Post-varicella polyneuritis. Brit. med. J. 1:908, 1965.

[7] 7. COOK, S.D. & DOWLING, P.C. - The role ot autoantibody and immune complexes in the pathogenesis of Guillain-Barré syndrome. Ann. Neurol. 9 (suppl.):70, 1981.

[8] 8. COUCHOT, J.; PENNAFORTE, J.C.; FERRAND, B.L. & RULLIER, J. - Syndrome de Guillain-Barré au décours d'une varicelle. Nouv. Presse méd. 7:47, 1978.

[9] 9. DAVIES, J. & ROWLATT, R.J. - Transient severe hypertension and polyradiculitis after chickenpox. Brit. med. J. 2:1608, 1978.

[10] 10. DOWLING, P.C. & COOK, S.D. - Role of infection in Guillain-Barré syndrome: laboratory confirmation of herpesviruses in 41 cases. Ann. Neurol. 9 (suppl):44, 1981.

[11] 11. EATON, O.M.; STEVENS, H. & SILVER, H.M. - Respiratory failure in polyradiculoneuritis associated with infectious mononucleosis. J. amer. med. Assoc. 194:609, 1965.

[12] 12. GARVEY, P.H.; JONES, N. & WARREN, S.L. - Polyradiculoneuritis (Guillain-Barré syndrome) following the use of sulfanilamide and fever therapy. J. amer. med. Assoc. 115:1955, 1940.

[13] 13. GUERIN, J.M.; RAUX, M. & LAMOTTE, M. - Syndrome de Guillain-Barré après rougeole. Sem. Hop. Paris 57:1215, 1981.

[14] 14. GUERREIRO, C.A.M.; FACURE, N.O.; GONÇALVES JUNIOR, F.L.; SILVA, L. J.; RAMOS, M.C. & PEDRO, R.J. - Polirradiculoneurite e malária. Arq. Neuro-Psiquiat. (São Paulo) 43:214, 1985.

[15] 15. HODGES, G.R. & PERKIN, R.L. - Landry-Guillain-Barré syndrome associated with Mycoplasma pneumoniae infection. J. amer. med. Assoc. 210:2088, 1969.

[16] 16. HOLT, S.; KHAN, M.M.; CHARLES, R.G. & EPSTEIN, E.J. - Polyradiculoneuritis and Mycoplasma pneumoniae infection. Postgrad, med. J. 53:416, 1977.

[17] 17. IQBAL, A.; OGER, J.J.F. & ARNASON, G.W. - Cell-mediated immunity in idiopathic polyneuritis. Ann. Neurol. 9 (suppl.):65, 1981.

[18] 18. KOSKI, CL. - Guillain-Barré syndrome. Neurol. Clin. 2:355, 1984.

[19] 19. LAYZER, R.B. - Neuromuscular manifestations of systemic diseases. F.A. Davis Philadelphia, 1985.

[20] 20. MENKES, J.H. - Textbook of Child Neurology. Lea & Febiger, Philadelphia, 1985.

[21] 21. MENONNA, J.; GOLDSCHMIDT, B.; HAIDRI, N.; DOWLING, P. & COOK, S. - Herpes simplex virus-IgM specific antibodies in Guillain-Barré syndrome and encephalitis. Acta neurol. scand. 56:223, 1977.

[22] 22. MUSHINSKI, J.F.; TANIGUCHI, R.M. & STIEFEL, J.W. - Guillain-Barré syndrome associated with ulcero-glandular tularemia. Neurology 14:877, 1964.

[23] 23. PHILLIPS, P.E. - Guillain-Barré syndrome after measles. Brit. med. J. 4:50, 1972.

[24] 24. POLLACK, S.; BARON, E. & ENAT, R. - Guillain-Barré syndrome: association with mumps. N.Y. St. J. Med. 795, 1981.

[25] 25. RAB, S.M. & CHOUDHURY, G.M. - Landry-Guillain-Barré syndrome after chicken pox. N. Engl. J. Med. 268:200, 1963.

[26] 26. SAMANTRAY, S.K.; JOHNSON, S.C.; MATHAI, K.V. & PULIMOOD, B.M. - Landry-Guillain-Barré-Strohl syndrome: a estudy of 302 cases. Med. J. Aust. 2:84, 1977.

[27] 27. STEWART, G.J.; POLLARD, J.D.; McLEOD, J.G. & WOLNIZER, CM. - HLA antigens in the Landry Guillain-Barré syndrome and chronic relapsing polyneuritis. Ann. Neurol. 4:285, 1978.

[28] 28. TENSER, R.B. - Herpes simplex and herpes zoster. Neurol. Clin. 2:215, 1984.

[29] 29. TWOMEY, J.A. & JEFFERSON, D. - Encephalitis and polyneuritis complicating varicella zoster infection. Postgrad, med. J. 57:507, 1981.

[30] 30. WELCH, R.G. - Chicken-pox and the Guillain-Barré syndrome. Arch. Dis. Child. 37:557, 1962.

[31] 31. WELLER, T.H. - Varicella and herpes zoster: changing concepts of the natural history, control, and importance of a not-so-benign virus (two parts). N. Engl. J. Med. 309:1362, 1434, 1983.

[32] 32. ZIVIN, I. & SCHWAGER, V.A. - The Guillain-Barré syndrome as a complication of varicella. Dis. nerv. Syst. 33:742, 1972.