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Severe Acute Pancreatitis Complicated by Guillain-Barré Syndrome in the Intensive Care Unit
Dan Wang1, Xianlin Meng1, Tingting Ye1
1Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, China.
Abstract:
Severe acute pancreatitis (SAP) rarely causes immune-mediated neurological complications. We report Guillain-Barré syndrome (GBS), acute motor and sensory axonal neuropathy subtype, occurring during SAP requiring extracorporeal membrane oxygenation and continuous renal replacement therapy. A 39-year-old woman with hyperlipidemic pancreatitis and autoimmune diseases developed abrupt symmetric flaccid quadriplegia after sedation withdrawal in the intensive care unit. Electrophysiological studies and cerebrospinal fluid analysis confirmed the diagnosis of GBS. Intravenous immunoglobulin therapy resulted in gradual neurological improvement. This case highlights the diagnostic challenge of recognizing GBS in critically ill patients with SAP. Clinicians should suspect GBS when unexplained symmetric weakness occurs after sedation withdrawal and perform early electrophysiological evaluation with prompt immunomodulatory therapy.
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