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Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery

INTRODUCTION: There are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain–Barré and acute transverse myelitis...

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Autores principales: Stoian, Adina, Motataianu, Anca, Bajko, Zoltan, Balasa, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029401/
https://www.ncbi.nlm.nih.gov/pubmed/32104735
http://dx.doi.org/10.2478/jccm-2020-0008
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author Stoian, Adina
Motataianu, Anca
Bajko, Zoltan
Balasa, Adrian
author_facet Stoian, Adina
Motataianu, Anca
Bajko, Zoltan
Balasa, Adrian
author_sort Stoian, Adina
collection PubMed
description INTRODUCTION: There are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain–Barré and acute transverse myelitis overlap syndrome. In this article, we present the case of a second trimester pregnant patient who developed Guillain–Barré and acute transverse myelitis overlap syndrome. CASE PRESENTATION: We report the case of a 16-year-old female patient who underwent a therapeutic termination of pregnancy two weeks prior to the onset of the disease with gradual development of a motor deficit with walking and sensitivity disorders, fecal incontinence. The diagnosis was based on clinical exam, electroneurography and spinal magnetic resonance imaging. Endocrinopathies, infectious diseases, autoimmune and inflammatory diseases, neoplastic diseases and vitamin deficiencies were ruled out. Our patient attended five sessions of therapeutic plasma exchange, followed by steroid treatment, intravenous immunoglobulin with minimum recovery of the motor deficit in the upper limbs, but without significant evolution of the motor deficit in the lower limbs. The patient was discharged on maintenance corticotherapy and immunosuppressive treatment with azathioprine. CONCLUSIONS: We report a very rare association between Guillain–Barré syndrome and acute transverse myelitis triggered by a surgical intervention with general anaesthesia. The overlap of Guillain–Barré syndrome and acute transverse myelitis makes the prognosis for recovery worse, and further studies are needed to establish the first-line therapy in these cases.
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spelling pubmed-70294012020-02-26 Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery Stoian, Adina Motataianu, Anca Bajko, Zoltan Balasa, Adrian J Crit Care Med (Targu Mures) Case Report INTRODUCTION: There are rare reports of the occurrence of acute transverse myelitis and Guillain–Barré syndrome after various surgical procedures and general/epidural anaesthesia. The concomitant occurrence of these pathologies is very rare and is called Guillain–Barré and acute transverse myelitis overlap syndrome. In this article, we present the case of a second trimester pregnant patient who developed Guillain–Barré and acute transverse myelitis overlap syndrome. CASE PRESENTATION: We report the case of a 16-year-old female patient who underwent a therapeutic termination of pregnancy two weeks prior to the onset of the disease with gradual development of a motor deficit with walking and sensitivity disorders, fecal incontinence. The diagnosis was based on clinical exam, electroneurography and spinal magnetic resonance imaging. Endocrinopathies, infectious diseases, autoimmune and inflammatory diseases, neoplastic diseases and vitamin deficiencies were ruled out. Our patient attended five sessions of therapeutic plasma exchange, followed by steroid treatment, intravenous immunoglobulin with minimum recovery of the motor deficit in the upper limbs, but without significant evolution of the motor deficit in the lower limbs. The patient was discharged on maintenance corticotherapy and immunosuppressive treatment with azathioprine. CONCLUSIONS: We report a very rare association between Guillain–Barré syndrome and acute transverse myelitis triggered by a surgical intervention with general anaesthesia. The overlap of Guillain–Barré syndrome and acute transverse myelitis makes the prognosis for recovery worse, and further studies are needed to establish the first-line therapy in these cases. Sciendo 2020-01-31 /pmc/articles/PMC7029401/ /pubmed/32104735 http://dx.doi.org/10.2478/jccm-2020-0008 Text en © 2020 Adina Stoian, Anca Motataianu, Zoltan Bajko, Adrian Balasa, published by Sciendo http://creativecommons.org/licenses/by-nc-nd/4.0 This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
spellingShingle Case Report
Stoian, Adina
Motataianu, Anca
Bajko, Zoltan
Balasa, Adrian
Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title_full Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title_fullStr Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title_full_unstemmed Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title_short Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome Following Obstetric Surgery
title_sort guillain–barré and acute transverse myelitis overlap syndrome following obstetric surgery
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029401/
https://www.ncbi.nlm.nih.gov/pubmed/32104735
http://dx.doi.org/10.2478/jccm-2020-0008
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