Immune disorders linked to elevated risk of Guillain-Barré syndrome
Immune-related conditions that occur early in life appear to present a heightened risk of developing Guillain-Barré syndrome, suggesting that the pathophysiology of the said neurological disorder may extend beyond infectious triggers, according to a study.
The longitudinal cohort study included 1,108,541 parous women with 16,108,819 person-years of follow-up. Guillain-Barré syndrome was the primary outcome. Immune-mediated and rheumatological diseases, cancer, transfusion, surgical procedures and pregnancy-specific disorders were evaluated as potential risk factors for future development of the neurological disorder.
Guillain-Barré syndrome had an overall incidence of 1.42 per 100,000 person-years. The highest incidence was observed among women with immune-mediated (8.79 per 100,000 person-years) and rheumatological disorders (9.84 per 100,000 person-years), followed by those with transfusion (4.41 per 100,000 person-years) and pre-eclampsia (2.62 per 100,000 person-years).
Immune-mediated disorders were associated with a sixfold greater risk of developing Guillain-Barré syndrome (hazard ratio [HR], 6.57; 95 percent CI, 3.58 to 12.04). The corresponding HRs with rheumatological disorders, transfusion and pre-eclampsia were 7.23 (3.21 to 16.28), 3.58 (1.83 to 6.98) and 2.01 (1.29 to 3.12).
Other potential risk factors were not associated with an increased risk of Guillain-Barré syndrome.
Characterized by acute onset and progressive course, Guillain-Barré syndrome includes a set of clinical syndromes having an acute inflammatory polyneuropathy with an autoimmune aetiology. Poor clinical outcome is most common among patients who were treated in an intensive care unit (ICU) and required mechanical ventilation during the acute phase. ICU complications are often linked to prolonged ventilation, concomitant medical conditions or old age. [BMC Neurol 2013;13:95; J Neurol 2013;260:1367-74]