RESUMO
Plasmodium falciparum malaria is often complicated by involvement of the gastrointestinal, cardiovascular, and nervous systems. The development of Guillain-Barré syndrome in 10 patients who had had acute P. falciparum malaria during its seasonal exacerbation is reported.
Assuntos
Síndrome de Guillain-Barré/epidemiologia , Síndrome de Guillain-Barré/parasitologia , Malária Falciparum/epidemiologia , Doença Aguda , Adolescente , Adulto , Criança , Feminino , Síndrome de Guillain-Barré/sangue , Humanos , Malária Falciparum/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
Guillain-Barre's syndrome (GBS) associated with malarial infection is a rare condition reported in the literature. We report a case of Plasmodium falciparum (PF) malarial infection with Guillain-Barre's syndrome complicated by respiratory failure and review of the literature. Our patient gradually improved after treatment with plasma exchange. Review of the literature showed 11 cases of GBS associated with malaria. Four of 8 patients with GBS associated with PF had respiratory failure, whereas, none of the patients with GBS associated with Plasmodium vivax (PV) developed respiratory failure. Three of four patients with respiratory failure died and one who survived was treated with intravenous immunoglobulin. Our patient was the second case to survive after treatment with plasma exchange. The role of plasma exchange, the pathogenesis of malaria in GBS and the mechanism that induced more severe GBS in PF than in PV were discussed.
Assuntos
Síndrome de Guillain-Barré/parasitologia , Síndrome de Guillain-Barré/terapia , Malária Falciparum/complicações , Troca Plasmática , Insuficiência Respiratória/parasitologia , Insuficiência Respiratória/terapia , Adulto , Feminino , Humanos , Troca Plasmática/métodos , Quadriplegia/parasitologia , Quadriplegia/terapia , Respiração Artificial , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Malignant lymphoma may present prominent peripheral nervous system disorders with variable etiologies. We describe a patient who presented with chronic relapsing polyradiculoneuropathy accompanied by right facial nerve palsy. Gadolinium enhancement of the right facial nerve and cervical spinal roots was noted on magnetic resonance imaging (MRI). Sural nerve biopsy specimens showed mononuclear cell infiltration around the vessels in the epineurium. Histopathological and immunohistochemical investigations of sural nerve specimens revealed perivascular infiltration of lymphocytes with T-cell dominancy. No apparent direct invasion of lymphoma cells was seen. The results of nerve conduction studies, sural nerve biopsy and cerebrospinal fluid examination were suggestive of immune-mediated inflammatory demyelinating neuropathy. The chronic and relapsing fashion and unique radiological findings in our patient expand on the previously reported features of peripheral neuropathy associated with peripheral T-cell lymphoma.