Guillain-Barre syndrome during the Zika virus outbreak in Northeast Brazil: An observational cohort study



Leonhard, Sonja E, Halstead, Susan, Lant, Suzannah B, de Albuquerque, Maria de Fatima Pessoa Militao, de Brito, Carlos Alexandre Antunes, de Albuquerque, Livia Brito Bezerra, Ellul, Mark A ORCID: 0000-0002-6115-8245, Franca, Rafael Freitas de Oliveira, Gourlay, Dawn, Griffiths, Michael J
et al (show 14 more authors) (2021) Guillain-Barre syndrome during the Zika virus outbreak in Northeast Brazil: An observational cohort study. JOURNAL OF THE NEUROLOGICAL SCIENCES, 420. 117272-.

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Abstract

<h4>Objective</h4>To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil.<h4>Methods</h4>We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids.<h4>Results</h4>Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently.<h4>Conclusion</h4>A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS.

Item Type: Article
Uncontrolled Keywords: Guillain-Barre syndrome, Zika virus, Chikungunya virus, Arbovirus, Neuroinflammatory disease
Depositing User: Symplectic Admin
Date Deposited: 08 Jan 2021 14:55
Last Modified: 18 Jan 2023 23:05
DOI: 10.1016/j.jns.2020.117272
Open Access URL: https://www.jns-journal.com/article/S0022-510X(20)...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3112055