RESUMO
INTRODUCTION: After Zika virus outbreak and the increase in the incidence of Guillain-Barre syndrome (GBS), the causal relationship has been studied, however a full etiological correlation has not been found. PATIENTS AND METHODS: From January 1 to December 31, 2017, patients with GBS were included. In addition to the basic serologies, enterovirus, herpes, Campylobacter, hepatitis B and C, TORCH, HIV, Brucella and Salmonella were requested. RESULTS: Cohort of seven male patients. Five patients analyzed cerebrospinal fluid reporting normal; all of them underwent brain scan, reporting normal. Neuroconduction was performed, resulting in acute inflammatory demyelinating polyneuropathy in four cases and acute motor axonal neuropathy in one case. All received intravenous immunoglobulins, five cases had a good prognosis and two deaths. No positive cases were reported to Zika virus. A positive case was reported to dengue and another to chikungunya. Five positive cases were reported to Campylobacter. One case positive to enterovirus. Dengue + Campylobacter coinfections were reported in one case and chikungunya + Campylobacter in another case. CONCLUSIONS: The present cohort shows that it was not possible to establish a causal relationship between GBS and Zika virus, but other viral and bacterial causal agents were identified, such as dengue, chikungunya and enterovirus, with the identification of Campylobacter cases even more remarkable.
TITLE: Agentes causales mas frecuentes del sindrome de Guillain-Barre en un hospital de Veracruz, Mexico.Introduccion. Con posterioridad a la oleada del virus del Zika y el incremento en la incidencia de sindrome de Guillain-Barre (SGB), se ha estudiado la relacion causal, pero no se ha encontrado una plena correlacion etiologica. Pacientes y metodos. Del 1 de enero al 31 de diciembre de 2017, se incluyeron pacientes con SGB. Ademas de las serologias basicas, se solicitaron determinaciones de enterovirus, virus del herpes, Campylobacter, hepatitis B y C, TORCH, virus de la inmunodeficiencia humana, Brucella y Salmonella. Resultados. Cohorte de siete pacientes de sexo masculino. A cinco pacientes se les analizo el liquido cefalorraquideo, que era normal. A todos se les realizo una tomografia encefalica, tambien normal, y se realizo neuroconduccion, que mostro polineuropatia inflamatoria desmielinizante aguda en cuatro casos y neuropatia motora axonal aguda en uno. Todos recibieron inmunoglobulinas intravenosas; tuvieron buen pronostico cinco casos y hubo dos defunciones. No se informo de casos positivos al virus del Zika. Hubo un caso positivo al dengue, uno al chikungunya, cinco a Campylobacter y uno a enterovirus. Se informo de coinfecciones de dengue + Campylobacter en un caso y de chikungunya + Campylobacter en otro. Conclusiones. La presente cohorte demuestra que no fue posible establecer una relacion causal entre el SGB y el virus del Zika, pero se identificaron otros agentes causales viricos y bacterianos, como dengue, chikungunya y enterovirus, y fue aun mas destacable la identificacion de los casos de Campylobacter.
