Clinical and biochemical profile of Guillain Barré Syndrome in Pakistan

OBJECTIVES: To evaluate the frequency, distribution, characteristics, and biochemical features of Guillain-Barré syndrome (GBS). METHODS: This retrospective, case-control study was conducted between November 2018 and February 2020 at PIMS Hospital, Islamabad and Arid Agriculture University, Rawalpindi, Pakistan. The GBS patients were diagnosed through physical examination and nerve conduction study (NCS). Hemoglobin (Hb), liver function tests, renal function tests, lipid profile, and interleukin-17 levels were investigated through the blood. Cerebrospinal fluid analysis (CSF) was performed to measure albuminocytological dissociation (ACD). RESULTS: One hundred and ten patients and 130 controls participated in this study. Fifty-nine (53.63 %) patients had gastrointestinal infection while 52 (47.27 %) had AIDP. IL-17 serum levels were associated with GBS showing elevated values 18.49 pg/mL (SD=4.10) in cases as compared to controls 10.66 (SD=2.09), p<0.001. The CSF proteins were statistically significant in GBS patients, 127.93 mg/dL (SD=51.28), p=0.002. Ascending weakness was observed in 82 (74.5 %) patients. The results showed that the mean age value of GBS patients was 41.27 years, showing males preponderance. The mean Hb value for males and females was 14.83 g/dL and 10.88 g/dL respectively. Seasonal trends in the disease showed that 40% of GBS patients had infections during the spring. CONCLUSION: The results of the current study suggest that IL-17 levels trigger autoimmunity in GBS patients. The ACD could be used as a diagnostic marker of GBS along with NCS. Antecedent infections were common in a majority of GBS patients.