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Neuropediatrics 2022; 53(04): 235-238
DOI: 10.1055/s-0042-1742721
Original Article

Post-CMV Guillain-Barré Syndrome with Anti-GM2 Antibodies: Two Cases and a Review of the Literature

Alice Manaud
1   Unité de Neuropédiatrie, Hôpital des enfants, CHU Toulouse, Toulouse, France
,
Amandine Geraudie
2   Unité de Neurologie, Hôpital Pierre Paul Riquet, CHU Toulouse, Toulouse, France
,
Agnès Viguier
1   Unité de Neuropédiatrie, Hôpital des enfants, CHU Toulouse, Toulouse, France
,
Catherine Mengelle
3   Laboratoire de Virologie, Hôpital Pierre Paul Riquet, CHU Toulouse, Toulouse, France
,
Françoise Fortenfant
4   Laboratoire d'Immunologie, Hôpital Pierre Paul Riquet, CHU Toulouse, Toulouse, France
,
Eloïse Baudou
1   Unité de Neuropédiatrie, Hôpital des enfants, CHU Toulouse, Toulouse, France
,
Emmanuel Cheuret
1   Unité de Neuropédiatrie, Hôpital des enfants, CHU Toulouse, Toulouse, France
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Abstract

Introduction Guillain-Barré syndrome (GBS) is an acute post-infectious inflammatory polyneuropathy of ubiquitous distribution. Cytomegalovirus (CMV) is the virus that is most frequently involved. All ages are affected but rare pediatric cases seem to show some distinctive features in terms of specificity and severity. Specific antibodies that target the peripheral nervous system have been identified in several forms of GBS in adults, such as anti-GM2 ganglioside antibodies in post-CMV GBS, which in most instances present as demyelinating polyneuropathies, with a more favorable progression and fewer complications.

Materials and Methods This is a retrospective report on two cases of post-CMV GBS with a demyelinating disorder and positive for anti-GM2 IgM. The review of the literature examines five other cases of children with post-CMV GBS with anti-GM2 IgM.

Results In terms of progression, our two cases of post-CMV GBS with a demyelinating disorder and anti-GM2 IgM are similar to the five other cases described in the literature. The CMV infection was asymptomatic or paucisymptomatic and involved girls (6/7), often presenting severe motor forms with frequent loss of the ability to walk (4/6), facial involvement (⅗), little respiratory involvement (⅙), and favorable progression with adapted treatment.

Conclusion Post-CMV GBS with anti-GM2 IgM is a specific clinical spectrum that seems to affect children as it affects adults with a predominance among females, demyelination, and severe motor involvement, but a good prognosis. On the other hand, unlike adults, the use of assisted ventilation does not seem to be more frequent.

Keywords

child - Guillain-Barré syndrome - anti-GM2 antibodies - cytomegalovirus


Publication History

Received: 04 August 2021

Accepted: 20 December 2021

Article published online:
18 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
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