The mechanism responsible for hypertension in a patient with Guillain-Barré syndrome
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1Second Department of Internal Medicine, Tohoku University of School of Medicine, Sendai, Japan.
Insights
This study details a hypertension case linked to Guillain-Barré syndrome, noting disrupted blood pressure rhythms. Findings suggest autonomous sympathetic nervous system hyperactivity may cause sustained hypertension.
Area of Science:
- Neurology
- Cardiology
- Endocrinology
Background:
- Guillain-Barré syndrome (GBS) is an autoimmune disorder affecting the peripheral nervous system.
- Hypertension is a known, though less common, complication of GBS.
- Understanding the mechanisms of GBS-associated hypertension is crucial for patient management.
Observation:
- A patient with Guillain-Barré syndrome presented with sustained hypertension.
- Circadian variations in blood pressure were absent.
- Neurohumoral evaluation indicated a hyperactive sympathetic nervous system with elevated plasma renin activity.
Findings:
- Serum norepinephrine and epinephrine levels remained high despite treatment with clonidine, a central sympatholytic agent.
- This suggests that the hypertension was not primarily driven by central sympathetic outflow.
- The findings point towards hyperactivity in the efferent pathways of the sympathetic nervous system.
Implications:
- Autonomous efferent sympathetic hyperactivity may be the cause of sustained, non-dipping hypertension in some GBS cases.
- This case highlights the complex interplay between neurological and cardiovascular systems in GBS.
- Further research into neurogenic hypertension mechanisms in GBS is warranted.
Abstract:
We report a case of hypertension associated with Guillain-Barré syndrome. In this case, the circadian variation of blood pressure was interrupted. Examination of neurohumoral factors revealed a hyperactive sympathetic nervous system and an increase in plasma renin activity. Clonidine, which acts centrally to inhibit sympathetic outflow, did not suppress serum norepinephrine or epinephrine. These observations suggest that autonomous hyperactivity of the efferent pathway of the sympathetic nervous system may cause the sustained hypertension throughout the day in this case.