Leonhard, Sonja E., van der Eijk, Annemiek A., Andersen, Henning, Antonini, Giovanni, Arends, Samuel ORCID: 0000-0003-4279-4657, Attarian, Shahram, Barroso, Fabio A., Bateman, Kathleen J., Batstra, Manou R., Benedetti, Luana, van den Berg, Bianca, Van den Bergh, Peter, Burmann, Jan, Busby, Mark, Casasnovas, Carlos, Cornblath, David R., Davidson, Amy, Doets, Alex Y., van Doorn, Pieter A., de la Cour, Charlotte Dornonville, Feasby, Thomas E., Fehmi, Janev, Garcia-Sobrino, Tania, Goldstein, Jonathan M., Gorson, Kenneth C., Granit, Volkan, Hadden, Robert D. M., Harbo, Thomas, Hartung, Hans-Peter, Hasan, Imran, Holbech, Jakob, V, Holt, James K. L., Jahan, Israt, Islam, Zhahirul, Karafiath, Summer, Katzberg, Hans D., Kleyweg, Ruud P., Kolb, Noah, Kuitwaard, Krista, Kuwahara, Motoi, Kusunoki, Susumu, Luijten, Linda W. G., Kuwabara, Satoshi, Pan, Edward Lee, Lehmann, Helmar C., Maas, Marijke, Martin-Aguilar, Lorena ORCID: 0000-0002-1553-2224, Al Miller, James, Mohammad, Quazi Deen, Monges, Soledad, Nedkova-Hristova, Velina, Nobile-Orazio, Eduardo, Pardo, Julio, Pereon, Yann, Querol, Luis, Reisin, Ricardo, Van Rijs, Wouter, Rinaldi, Simon, Roberts, Rhys C., Roodbol, Joyce, Shahrizaila, Nortina, Sindrup, Soren Hein, Stein, Beth, Cheng-Yin, Tan, Tankisi, Hatice, Tio-Gillen, Anne P., Tous, Maria J. Sedano, Verboon, Christine, Vermeij, Frederique H., Visser, Leo H., Huizinga, Ruth, Willison, Hugh J. and Jacobs, Bart C. (2022). An International Perspective on Preceding Infections in Guillain-Barre Syndrome The IGOS-1000 Cohort. Neurology, 99 (12). S. E1299 - 15. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1526-632X

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Abstract

Background and Objectives Infections play a key role in the development of Guillain-Barre syndrome (GBS) and have been associated with specific clinical features and disease severity. The clinical variation of GBS across geographical regions has been suggested to be related to differences in the distribution of preceding infections, but this has not been studied on a large scale. Methods We analyzed the first 1,000 patients included in the International GBS Outcome Study with available biosamples (n = 768) for the presence of a recent infection with Campylobacter jejuni, hepatitis E virus, Mycoplasma pneumoniae, cytomegalovirus, and Epstein-Barr virus. Results Serologic evidence of a recent infection with C. jejuni was found in 228 (30%), M. pneumoniae in 77 (10%), hepatitis E virus in 23 (3%), cytomegalovirus in 30 (4%), and Epstein-Barr virus in 7 (1%) patients. Evidence of more than 1 recent infection was found in 49 (6%) of these patients. Symptoms of antecedent infections were reported in 556 patients (72%), and this proportion did not significantly differ between those testing positive or negative for a recent infection. The proportions of infections were similar across continents. The sensorimotor variant and the demyelinating electrophysiologic subtype were most frequent across all infection groups, although proportions were significantly higher in patients with a cytomegalovirus and significantly lower in those with a C. jejuni infection. C. jejuni-positive patients were more severely affected, indicated by a lower Medical Research Council sum score at nadir (p = 0.004) and a longer time to regain the ability to walk independently (p = 0.005). The pure motor variant and axonal electrophysiologic subtype were more frequent in Asian compared with American or European C. jejuni-positive patients (p < 0.001, resp. p = 0.001). Time to nadir was longer in the cytomegalovirus-positive patients (p = 0.004). Discussion Across geographical regions, the distribution of infections was similar, but the association between infection and clinical phenotype differed. A mismatch between symptom reporting and serologic results and the high frequency of coinfections demonstrate the importance of broad serologic testing in identifying the most likely infectious trigger. The association between infections and outcome indicates their value for future prognostic models.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Leonhard, Sonja E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Eijk, Annemiek A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Andersen, HenningUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arends, SamuelUNSPECIFIEDorcid.org/0000-0003-4279-4657UNSPECIFIED
Attarian, ShahramUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barroso, Fabio A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bateman, Kathleen J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Batstra, Manou R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benedetti, LuanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van den Berg, BiancaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van den Bergh, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burmann, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Busby, MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Casasnovas, CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornblath, David R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Davidson, AmyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doets, Alex Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Doorn, Pieter A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de la Cour, Charlotte DornonvilleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Feasby, Thomas E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fehmi, JanevUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Garcia-Sobrino, TaniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goldstein, Jonathan M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gorson, Kenneth C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Granit, VolkanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hadden, Robert D. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harbo, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartung, Hans-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasan, ImranUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holbech, Jakob, VUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holt, James K. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jahan, IsratUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Islam, ZhahirulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karafiath, SummerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katzberg, Hans D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kleyweg, Ruud P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kolb, NoahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuitwaard, KristaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuwahara, MotoiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kusunoki, SusumuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luijten, Linda W. G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuwabara, SatoshiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pan, Edward LeeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehmann, Helmar C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maas, MarijkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martin-Aguilar, LorenaUNSPECIFIEDorcid.org/0000-0002-1553-2224UNSPECIFIED
Al Miller, JamesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohammad, Quazi DeenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monges, SoledadUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nedkova-Hristova, VelinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nobile-Orazio, EduardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pardo, JulioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pereon, YannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Querol, LuisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reisin, RicardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Van Rijs, WouterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rinaldi, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roberts, Rhys C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roodbol, JoyceUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shahrizaila, NortinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sindrup, Soren HeinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stein, BethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cheng-Yin, TanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tankisi, HaticeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tio-Gillen, Anne P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tous, Maria J. SedanoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Verboon, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vermeij, Frederique H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser, Leo H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huizinga, RuthUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willison, Hugh J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobs, Bart C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-699229
DOI: 10.1212/WNL.0000000000200885
Journal or Publication Title: Neurology
Volume: 99
Number: 12
Page Range: S. E1299 - 15
Date: 2022
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1526-632X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CAMPYLOBACTER-JEJUNI INFECTION; HEPATITIS-E; CYTOMEGALOVIRUS-INFECTION; ANTIBODIES; CELLSMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69922

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