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Revista mexicana de neurociencia
versão On-line ISSN 2604-6180versão impressa ISSN 1665-5044
Resumo
SOLANA-ROJAS, Ángel et al. Clinical severity and associated complications in pediatric patients with Guillain-Barré syndrome. Rev. mex. neurocienc. [online]. 2020, vol.21, n.1, pp.15-26. Epub 22-Mar-2022. ISSN 2604-6180. https://doi.org/10.24875/rmn.19000014.
Background:
Guillain-Barré syndrome (GBS) is an acute demyelinating polyradiculoneuropathy, of autoimmune origin, with heterogeneous clinical variants. It is the most frequent cause of flaccid paralysis in children. Incidence of 0.38-0.91 cases per 100,000, rare in children under 2 years.
Objective:
The objective of the study was to describe the clinical severity and complications in pediatric patients aged 1-18 years with GBS.
Methods:
A descriptive and retrospective analysis was carried out. We collected data from clinical files of patients of Legaria Pediatric Hospital with stellate ganglion block, period of 3 years (January 2015-December 2017).
Results:
Twenty-four patients, 18 men (75%) and 6 women (25%) were included in the study. The average age of 7.33 years (range: 1-16 years). School patients were the most affected (45.8%). Nearly 62.5% had previous respiratory infection. The most frequent clinical variant was acute inflammatory demyelinating (62.5%), axonal motor syndrome (29.2%), and Miller Fisher syndrome (8.3%). Nearly 16.7% presented dysautonomies requiring mechanical ventilation. Nearly 50% presented albuminocytological dissociation. The most frequent degree of clinical severity at admission was Grade IV on the Hughes scale (54.2%). The degree of clinical severity most frequent at discharge was Grade II on the Hughes scale (33.3%). Only 41.7% of patients received treatment with intravenous immunoglobulin (IVIG) at 1 g/kg/dia for 2 days.
Conclusions:
By means of contingency tables, the association between degree of severity at admission and discharge of GBS with respect to treatment with IVIG was determined. There is a 3.8 times greater risk of severity in patients without receiving the ideal treatment.
Palavras-chave : Guillain Barre; Pediatrics; Mechanic Ventilation.