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Guillain-Barré syndrome presenting as mimicking croup

Shao-Hsuan Hsia1, Jainn-Jim Lin, Chang-Teng Wu

  • 1Divisions of Pediatric Critical Care and Emergency Medicine,Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.

The American Journal of Emergency Medicine
|July 20, 2010
PubMed

Insights

Pediatric stridor can mimic croup but may signal rare conditions like Guillain-Barré syndrome (GBS). Early recognition of atypical GBS symptoms, including vocal cord paralysis, is crucial for timely management.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Otolaryngology

Background:

  • Stridor is a common symptom of pediatric upper airway obstruction, often caused by infections like croup.
  • Less common etiologies of stridor require consideration in the differential diagnosis for accurate patient management.

Observation:

  • A 3-year-old girl presented with progressive hoarseness, barking cough, and dyspnea, initially resembling croup.
  • Following admission, she developed muscle weakness and areflexia, indicating a neurological compromise.
  • Flexible laryngoscopy revealed bilateral vocal cord paralysis, a critical finding in the airway assessment.

Findings:

  • The patient was diagnosed with Guillain-Barré syndrome (GBS), an autoimmune disorder affecting the peripheral nervous system.
  • Bilateral vocal cord paralysis was identified as an atypical presenting symptom of GBS in this pediatric case.
  • The clinical presentation initially mimicked common infectious causes of pediatric stridor.

Implications:

  • This case highlights the importance of considering neurological disorders, such as GBS, in the differential diagnosis of pediatric stridor.
  • Early identification of atypical GBS presentations, including vocal cord paralysis, is essential for prompt diagnosis and treatment.
  • Recognizing unusual symptoms of GBS can prevent diagnostic delays and ensure appropriate critical care interventions.

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