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Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study

David Orlikowski1, Raphaël Porcher, Valérie Sivadon-Tardy

  • 1Service de Réanimation, AP-HP, Hôpital Raymond Poincaré, Garches, France.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 24, 2011
PubMed

Insights

Cytomegalovirus (CMV) infection can cause Guillain-Barré syndrome (GBS), with similar risks to Campylobacter jejuni infection. Factors like older age and ventilation impact long-term outcomes in CMV-GBS patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Epidemiology and prognostic factors of cytomegalovirus (CMV) infection-associated Guillain-Barré syndrome (GBS) are poorly understood.
  • Cytomegalovirus (CMV) is a common virus with potential neurological complications.

Purpose of the Study:

  • To investigate the epidemiology of Guillain-Barré syndrome (GBS) following primary cytomegalovirus (CMV) infection.
  • To identify prognostic factors associated with CMV-GBS and long-term neurological sequelae.

Main Methods:

  • Prospective follow-up of 506 GBS patients from 1996-2006.
  • Diagnosis of 63 CMV-GBS cases using IgM and IgG avidity tests; plasma CMV DNA detection.
  • Statistical analysis including Fisher's exact test, Wilcoxon rank-sum test, and time series analysis.

Main Results:

  • CMV-GBS predominantly affected young adults but included a subgroup of women over 50.
  • Sensory defects (72%) and facial palsy (49%) were common; CMV DNA in plasma correlated with sensory defects.
  • Long-term neurological sequelae (21%) were linked to older age and mechanical ventilation.
  • CMV-GBS cases showed a decreasing trend (1996-2006) and seasonal periodicity (July-October).
  • Estimated incidence of CMV-GBS was 0.6-2.2 per 1000 primary CMV infections.

Conclusions:

  • The risk of GBS following primary CMV infection is comparable to that of Campylobacter jejuni infection.
  • Findings suggest viral replication plays a role in the neuropathology of CMV-GBS.
  • This study enhances understanding of CMV-GBS epidemiology and clinical characteristics.
Abstract

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