Simultaneous Occurrence of Axonal Guillain-Barré Syndrome in Two Siblings Following Dengue Infection

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Guillain-Barré syndrome (GBS) is a rare neurological complication following dengue viral infection.
• GBS presents as either acute inflammatory demyelinating polyneuropathy or axonal variants (acute motor axonal and acute sensory and motor axonal).
• Axonal variants of GBS are particularly infrequent.

Observation:

• Two brothers, aged 18 and 15, presented simultaneously with acute symmetric upper- and lower-limb weakness.
• Neither sibling had overt dengue fever symptoms preceding their neurological presentation.
• Both patients exhibited flaccid areflexic pure motor quadriparesis, with positive Dengue IgM serology.

Findings:

• Nerve conduction studies revealed predominant axonopathic changes in both affected brothers.
• Both patients demonstrated significant improvement with conservative management during their 7-day hospital stay.
• This case represents an unusual occurrence of dengue-associated axonal GBS in siblings.

Implications:

• The simultaneous occurrence of GBS in siblings raises questions about potential genetic predisposition or shared environmental triggers.
• Further research is needed to elucidate the mechanisms underlying dengue-associated GBS, particularly axonal variants.
• This report underscores the importance of considering GBS in patients with neurological symptoms following dengue infection, even in the absence of typical fever.