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Guillain-Barre syndrome and SIADH
Kondanath Saifudheen1, James Jose, V Abdul Gafoor
1Department of Neurology, Medical College, Kerala, India. drsaifu@yahoo.co.in
Neurology
|February 23, 2011
Summary
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is common in Guillain-Barré syndrome (GBS), affecting 48% of patients. SIADH indicates a more severe GBS course and poorer prognosis, necessitating closer monitoring.
Area of Science:
- Neurology
- Endocrinology
- Internal Medicine
Background:
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an often overlooked complication in Guillain-Barré syndrome (GBS).
- Previous observations are predominantly case reports, lacking systematic study.
- This study addresses the need for comprehensive data on SIADH in GBS.
Purpose of the Study:
- To determine the incidence and clinical characteristics of SIADH in GBS patients.
- To evaluate SIADH as a predictor of GBS severity and patient outcomes.
- To investigate the association between SIADH and mortality in GBS.
Main Methods:
- Prospective study of 50 GBS patients over 16 months in a tertiary care hospital.
- Diagnosis of SIADH based on modified Bartter and Schwartz criteria.
- Assessment of GBS severity using MRC sumscore, electrophysiologic studies, and clinical parameters.
Main Results:
- SIADH detected in 48% of GBS patients, with a median onset 8.8 days after GBS diagnosis.
- Patients with SIADH exhibited higher MRC sumscores, increased bulbar weakness, and greater need for ventilatory support.
- Longer hospitalization (29.15 vs 10.57 days) and higher plasmapheresis rates (23 vs 8) were observed in GBS patients with SIADH.
Conclusions:
- SIADH is a frequent and significant electrolyte disorder in GBS.
- SIADH is strongly associated with GBS severity and serves as an indicator of poor prognosis.
- While often asymptomatic, SIADH can manifest symptomatically and impacts GBS patient outcomes.
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