Mario B Prado1, Karla M Narito2, Karen Joy B Adiao3. 1. Section of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines- Manila, Manila, Philippines; Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila, Manila, Philippines; Division of Neurophysiology, Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan. Electronic address: mbprado@alum.up.edu.ph. 2. Department of Pediatrics, Urdaneta District Hospital, Urdaneta City, Pangasinan, Philippines. 3. Section of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines- Manila, Manila, Philippines.
Abstract
INTRODUCTION: While children of all ages may be affected by Guillain-Barre-Syndrome (GBS), there are no reports of Dengue Fever (DF) as the preceding or concurrent infection in this age group. In addition, the presence of anti-GM1 IgM antibody, commonly seen in Multifocal Motor Neuropathy, is rarely encountered in both axonal and demyelinating variants of GBS. Moreover, only few neuromuscular ultrasound findings of the axonal variant in children were reported in the literature. CASE: Here we present a nine-year-old female who developed the classic signs, symptoms and neurophysiologic findings of axonal type of GBS during DF. She had elevated anti-GM1 IgM antibody atypical of this variant and diffusely enlarged nerves via neuromuscular ultrasound. CONCLUSION: In a pediatric patient with DF and acute flaccid paralysis, GBS should always be one of the considerations. Although rare, anti-ganglioside GM1 IgM antibody can still be found in axonal variant of GBS.
INTRODUCTION: While children of all ages may be affected by Guillain-Barre-Syndrome (GBS), there are no reports of Dengue Fever (DF) as the preceding or concurrent infection in this age group. In addition, the presence of anti-GM1 IgM antibody, commonly seen in Multifocal Motor Neuropathy, is rarely encountered in both axonal and demyelinating variants of GBS. Moreover, only few neuromuscular ultrasound findings of the axonal variant in children were reported in the literature. CASE: Here we present a nine-year-old female who developed the classic signs, symptoms and neurophysiologic findings of axonal type of GBS during DF. She had elevated anti-GM1 IgM antibody atypical of this variant and diffusely enlarged nerves via neuromuscular ultrasound. CONCLUSION: In a pediatric patient with DF and acute flaccid paralysis, GBS should always be one of the considerations. Although rare, anti-gangliosideGM1 IgM antibody can still be found in axonal variant of GBS.
Authors: Lakshmi Chauhan; Elizabeth Matthews; Amanda L Piquet; Andrés Henao-Martinez; Carlos Franco-Paredes; Kenneth L Tyler; David Beckham; Daniel M Pastula Journal: Curr Trop Med Rep Date: 2022-09-15