- Title
- Guillain-Barre syndrome post renal transplant: A systematic review
- Creator
- Ostman, Cecilia; Chacko, Bobby
- Relation
- Transplant Infectious Disease Vol. 21, Issue 1, no. e13021
- Publisher Link
- http://dx.doi.org/10.1111/tid.13021
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: Guillain-Barré syndrome (GBS) is a common ascending polyneuropathy in adults. It is often associated with preceding viral or diarrhoeal illness with cytomegalovirus (CMV), Epstein-Barr virus (EBV), or Campylobacter jejuni. Solid organ transplant recipients are more susceptible to opportunistic infections with CMV than the general population as a result of immunosuppressive therapies to prevent graft rejection. However, reports of GBS are rare in this population. Objective: To systematically review cases of GBS in renal transplant patients to evaluate causative pathogens or triggers, management and associated morbidity and mortality. Methods and results: We conducted a systematic search of the MEDLINE database uncovering 17 cases of GBS in renal transplant patients in the literature. The majority of cases were in males (81%) and patients who received deceased donor renal transplants (87%). The mean age was 44.7 years (SD 13). The time between transplant and onset of symptoms ranged from 2 days to 10 years (Mean = 720 days). GBS was commonly associated with antecedent viral (CMV 12; EBV 1) or diarrhoeal (2) illness while two cases were attributed to calcineurin inhibitor use. All patients recovered fully or partially after treatment with anti-viral or anti-bacterial agents, immunoglobulins, and/or plasma exchange. Conclusion: Cytomegalovirus is the most common trigger for GBS in the post-renal transplant setting. Other triggers include campylobacter jejuni and calcineurin inhibitors. GBS should be considered in transplant patients presenting with weakness or paralysis in order to institute timely management.
- Subject
- cytomegalovirus; guillain‐barré syndrome; immunoglobulin therapy; plasma exchange; renal transplant
- Identifier
- http://hdl.handle.net/1959.13/1460381
- Identifier
- uon:45947
- Identifier
- ISSN:1398-2273
- Language
- eng
- Reviewed
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