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. 2024 Jul;271(7):4067-4074.
doi: 10.1007/s00415-024-12295-3. Epub 2024 Apr 4.

Takotsubo cardiomyopathy in Guillain-Barré syndrome

Atsushi Terayama  1 , Motoi Kuwahara  2 , Keisuke Yoshikawa  1 , Yuko Yamagishi  1 , Makoto Samukawa  1 , Shoko Yamashita  1 , Kyohei Onishi  3 , Tomoya Nagano  4 , Chikao Tatsumi  5 , Junko Ishii  6 , Michi Kawamoto  6 , Takashi Tokashiki  7 , Shoko Deguchi  8 , Kentaro Deguchi  8 , Atsushi Ishida  9 , Yasuhiko Baba  9 , Shigeki Yamaguchi  10 , Susumu Kusunoki  1   11 , Yoshitaka Nagai  1
Affiliations

Takotsubo cardiomyopathy in Guillain-Barré syndrome

Atsushi Terayama et al. J Neurol. 2024 Jul.

Abstract

Background and purpose: Takotsubo cardiomyopathy (TCM) is a serious autonomic complication of Guillain-Barré syndrome (GBS). However, the association between TCM and GBS has not been investigated in detail. We investigated the characteristics of GBS patients with TCM (GBS-TCM).

Methods: Clinical features and anti-ganglioside antibody between the GBS-TCM patients and 62 classical GBS patients without TCM as control patients were compared.

Results: Eight GBS-TCM patients were identified, in whom TCM was diagnosed at a mean of 6.5 [range 3-42] days after the onset of GBS. The age at onset of GBS was elder in the GBS-TCM patients than in the control GBS patients (76.5 [56-87] vs. 52 [20-88] years, p < 0.01). Notably, cranial nerve deficits, particularly in the lower cranial nerves, were observed in all GBS-TCM patients (100% vs. 41.9%, p < 0.01). Additionally, the GBS-TCM patients showed a higher GBS disability score at nadir (5 [4-5] vs. 4 [1-5], p < 0.01), and lower Medical Research Council sum scores at admission and nadir (37 [30-44] vs. 48 [12-60] at admission, p < 0.05, and 20 [12-44] vs. 40 [0-60] at nadir, p < 0.05, respectively). Mechanical ventilation was more frequently required in the GBS-TCM patients (62.5% vs. 11.3%, p < 0.01). Three GBS-TCM patients were positive for anti-ganglioside antibodies.

Conclusions: TCM occurred at a relatively early phase of GBS. The characteristics of GBS-TCM were the elder, lower cranial nerve involvements, severe limb weakness, and respiratory failure.

Keywords: Anti-ganglioside antibody; Cranial nerve deficits; Guillain–Barré syndrome; Mechanical ventilation; Takotsubo cardiomyopathy.

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