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Acute paralytic poliomyelitis presenting as Guillain-Barré syndrome
M D Yohannan1, S Ramia, A R al Frayh
1Department of Paediatrics, King Khalid University Hospital, Riyadh, Saudi Arabia.
Insights
Four vaccinated children developed paralytic poliomyelitis, mimicking Guillain-Barré syndrome. Wild poliovirus type I was confirmed, suggesting prior oral polio vaccine may alter disease presentation.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Poliomyelitis, caused by poliovirus, is a serious infectious disease that can lead to paralysis.
Purpose of the Study:
- To investigate the clinical presentation and diagnosis of poliomyelitis in vaccinated children.
- To explore potential alterations in the clinical course of paralytic poliomyelitis following oral polio vaccine administration.
Main Methods:
- Case series analysis of four children presenting with acute ascending paralysis.
- Cerebrospinal fluid (CSF) analysis.
- Isolation of wild poliovirus type I.
- Serological testing for neutralizing antibodies against poliovirus.
Main Results:
- Clinical presentation and CSF findings initially simulated Guillain-Barré syndrome.
- Diagnosis of poliomyelitis was confirmed by poliovirus isolation and elevated antibody titers.
- All affected children had received primary vaccination with live attenuated oral poliovirus vaccine.
Conclusions:
- The clinical course of paralytic poliomyelitis may be modified in children previously vaccinated with the oral polio vaccine.
- This case series highlights the importance of considering poliomyelitis even in vaccinated populations presenting with GBS-like symptoms.
Abstract:
The initial clinical picture and CSF changes in four children with acute ascending paralysis simulated Guillain-Barré syndrome. However, diagnosis of poliomyelitis was confirmed on the basis of isolation of wild poliovirus type I and high neutralising antibody to it. The four children had received primary vaccination with live attenuated oral poliomyelitis vaccine. It is postulated that the clinical course of paralytic poliomyelitis may be altered in children who have previously been vaccinated with live oral vaccine.