Guillain-Barré syndrome and hyponatraemia

Area of Science:

• Neurology
• Nephrology
• Clinical Medicine

Background:

• Hyponatraemia is a known complication of Guillain-Barré syndrome (GBS).
• Intravenous immunoglobulin (IVIG) therapy, commonly used for GBS, can also lead to hyponatraemia.
• The study investigates the incidence and implications of low serum sodium in GBS patients.

Purpose of the Study:

• To document serum sodium levels in GBS patients during and after various treatments, including IVIG and positive pressure ventilation (PPV).
• To explore the role of pseudohyponatraemia as a contributing factor.
• To assess if hyponatraemia predicts a poorer outcome in GBS.

Main Methods:

• A clinical record audit was conducted on 84 patients diagnosed with GBS.
• Data were collected over a 10-year period at Christchurch Hospital, New Zealand.
• Serum sodium concentrations were analyzed in relation to GBS management procedures.

Main Results:

• 31% of GBS patients (26 out of 84) exhibited significantly low serum sodium (<133 mmol/L).
• In 12 cases, hyponatraemia developed during or after IVIG administration, suggesting pseudohyponatraemia.
• Significantly hyponatraemic patients had a higher mortality rate (P=0.001), as did older patients (P=0.007) and those requiring ventilation (P=0.002).

Conclusions:

• Significant hyponatraemia is prevalent in GBS patients, with IVIG potentially contributing via pseudohyponatraemia.
• Hyponatraemia appears to be linked to a poorer prognosis in GBS.
• It is challenging to isolate hyponatraemia as an independent predictor due to confounding factors like advanced age and PPV.