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Case Reports
. 2018 Mar 27;18(1):143.
doi: 10.1186/s12879-018-3049-1.

Guillain-Barre syndrome associated with hemorrhagic fever with renal syndrome in China: a case report

Jie Jiao  1 , Lei Wu  2 , Jianyuan Yin  1 , Xiaojiao Quan  1 , Wei Chen  3 , Jie Hu  4
Affiliations
Case Reports

Guillain-Barre syndrome associated with hemorrhagic fever with renal syndrome in China: a case report

Jie Jiao et al. BMC Infect Dis. .

Abstract

Background: We describe a case of Guillain-Barre syndrome (GBS) associated with hemorrhagic fever with renal syndrome. To our knowledge, only five cases of GBS associated with Hantavirus infection have been reported so far.

Case presentations: A 62-year-old man presented intermittent fever, chill and oliguria. According to remarkable leukocytosis, atypical lymphocytes, thrombocytopenia and former dwelling in hemorrhagic fever-endemic area, he was suspected as hemorrhagic fever with renal syndromeand certified with positive Hantavirus IgG. Later, the patient had symmetrical flaccid paralysis of all extremities. Electromyography showed peripheral nerve injury (mainly in axon). The patient was diagnosed as having acute motor sensory axonal neuropathy (AMSAN). After immunoglobulin infusion, patient showed progressive recovery and was transferred 3 weeks after his first admission to a rehabilitation center.

Conclusions: Our case was the 6th reported case of GBS associated with hemorrhagic fever with renal syndrome. Moreover, we for the first time classified the subtype of GBS (AMSAN) based on the electrophysiology characteristics. GBS should be suspected in patients who are already diagnosed as hemorrhagic fever with renal syndrome when delayed symmetrical limb paralysis occurs. Until recent now, GBS was only reported in hemorrhagic fever patients in Europe and Asia, which termed as hemorrhagic fever with renal syndrome.

Keywords: Acute kidney injury; Guillain-Barre syndrome; Hantavirus; Hemorrhagic fever with renal syndrome.

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Not applicable.

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Written informed consent was obtained from the patient himself for publication of this case report and any accompanying images. A copy of written consent is available for review by the Editor of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Brain MRI showing normal signal in mesocephalon (left) and basal ganglia region (right) in T2-weighted
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References

    1. Mattar S, Guzman C, Figueiredo LT. Diagnosis of hantavirus infection in humans. Expert Rev Anti-Infect Ther. 2015;13(8):939–946. doi: 10.1586/14787210.2015.1047825. - DOI - PubMed
    1. Muranyi W, Bahr U, Zeier M, van der Woude FJ. Hantavirus infection. J Am Soc Nephrol. 2005;16(12):3669–3679. doi: 10.1681/ASN.2005050561. - DOI - PubMed
    1. Esposito S, Longo MR. Guillain-Barre syndrome. Autoimmun Rev. 2017;16(1):96–101. doi: 10.1016/j.autrev.2016.09.022. - DOI - PubMed
    1. Hiew FL, Ramlan R, Viswanathan S, Puvanarajah S. Guillain-Barre syndrome, variants & forms fruste: reclassification with new criteria. Clin Neurol Neurosurg. 2017;158:114–118. doi: 10.1016/j.clineuro.2017.05.006. - DOI - PubMed
    1. Rajabally YA, Durand MC, Mitchell J, Orlikowski D, Nicolas G. Electrophysiological diagnosis of Guillain-Barre syndrome subtype: could a single study suffice? J Neurol Neurosurg Psychiatry. 2015;86(1):115–119. doi: 10.1136/jnnp-2014-307815. - DOI - PubMed

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