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Guillain-Barré syndrome.
Lancet. 2021 03 27; 397(10280):1214-1228.Lct

Abstract

Guillain-Barré syndrome is the most common cause of acute flaccid paralysis worldwide. Most patients present with an antecedent illness, most commonly upper respiratory tract infection, before the onset of progressive motor weakness. Several microorganisms have been associated with Guillain-Barré syndrome, most notably Campylobacter jejuni, Zika virus, and in 2020, the severe acute respiratory syndrome coronavirus 2. In C jejuni-related Guillain-Barré syndrome, there is good evidence to support an autoantibody-mediated immune process that is triggered by molecular mimicry between structural components of peripheral nerves and the microorganism. Making a diagnosis of so-called classical Guillain-Barré syndrome is straightforward; however, the existing diagnostic criteria have limitations and can result in some variants of the syndrome being missed. Most patients with Guillain-Barré syndrome do well with immunotherapy, but a substantial proportion are left with disability, and death can occur. Results from the International Guillain-Barré Syndrome Outcome Study suggest that geographical variations exist in Guillain-Barré syndrome, including insufficient access to immunotherapy in low-income countries. There is a need to provide improved access to treatment for all patients with Guillain-Barré syndrome, and to develop effective disease-modifying therapies that can limit the extent of nerve injury. Clinical trials are currently underway to investigate some of the potential therapeutic candidates, including complement inhibitors, which, together with emerging data from large international collaborative studies on the syndrome, will contribute substantially to understanding the many facets of this disease.

Authors+Show Affiliations

Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: nortina@um.edu.my.Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

33647239

Citation

Shahrizaila, Nortina, et al. "Guillain-Barré Syndrome." Lancet (London, England), vol. 397, no. 10280, 2021, pp. 1214-1228.
Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré syndrome. Lancet. 2021;397(10280):1214-1228.
Shahrizaila, N., Lehmann, H. C., & Kuwabara, S. (2021). Guillain-Barré syndrome. Lancet (London, England), 397(10280), 1214-1228. https://doi.org/10.1016/S0140-6736(21)00517-1
Shahrizaila N, Lehmann HC, Kuwabara S. Guillain-Barré Syndrome. Lancet. 2021 03 27;397(10280):1214-1228. PubMed PMID: 33647239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guillain-Barré syndrome. AU - Shahrizaila,Nortina, AU - Lehmann,Helmar C, AU - Kuwabara,Satoshi, Y1 - 2021/02/26/ PY - 2020/01/27/received PY - 2020/05/07/revised PY - 2020/08/28/accepted PY - 2021/3/2/pubmed PY - 2021/3/2/medline PY - 2021/3/1/entrez SP - 1214 EP - 1228 JF - Lancet (London, England) JO - Lancet VL - 397 IS - 10280 N2 - Guillain-Barré syndrome is the most common cause of acute flaccid paralysis worldwide. Most patients present with an antecedent illness, most commonly upper respiratory tract infection, before the onset of progressive motor weakness. Several microorganisms have been associated with Guillain-Barré syndrome, most notably Campylobacter jejuni, Zika virus, and in 2020, the severe acute respiratory syndrome coronavirus 2. In C jejuni-related Guillain-Barré syndrome, there is good evidence to support an autoantibody-mediated immune process that is triggered by molecular mimicry between structural components of peripheral nerves and the microorganism. Making a diagnosis of so-called classical Guillain-Barré syndrome is straightforward; however, the existing diagnostic criteria have limitations and can result in some variants of the syndrome being missed. Most patients with Guillain-Barré syndrome do well with immunotherapy, but a substantial proportion are left with disability, and death can occur. Results from the International Guillain-Barré Syndrome Outcome Study suggest that geographical variations exist in Guillain-Barré syndrome, including insufficient access to immunotherapy in low-income countries. There is a need to provide improved access to treatment for all patients with Guillain-Barré syndrome, and to develop effective disease-modifying therapies that can limit the extent of nerve injury. Clinical trials are currently underway to investigate some of the potential therapeutic candidates, including complement inhibitors, which, together with emerging data from large international collaborative studies on the syndrome, will contribute substantially to understanding the many facets of this disease. SN - 1474-547X UR - https://www.unboundmedicine.com/medline/citation/33647239/Guillain-Barré_syndrome. L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(21)00517-1 DB - PRIME DP - Unbound Medicine ER -