Campylobacter jejuni infection in guillain-barré syndrome: A prospective case study in a tertiary care hospital.

Background: Guillain-Barré syndrome (GBS), the most frequent cause of acute flaccid paralysis worldwide, is a post infectious polyradiculoneuropathy. Preceding C. jejuni infection in patients of GBS and its co-relation to various subtypes of GBS have been studied. Methods: 50 patients of GBS were prospectively enrolled from PGIMER, Chandigarh a tertiary care hospital in India between August 2006 and July 2007. These patients were electrophysiologically categorized into subtypes. These patients and 40 age, sex and geographically matched controls were subjected to serology for C. jejuni (IgG and IgM) using ELISA and compared. Results: Evidence of recent C. jejuni infection was present in 30% of GBS patients compared to 8% of controls (15/50 vs 3/40 P<0.005). Preceding events in GBS patients were gastroentritis (32%), upper respiratory tract infection (14%) and fever (12%). 8 (47%) C. jejuni positive patients reported symptoms of gastroentritis (mean 13 days) prior to onset of GBS. 10/15(67%) patients of C. jejuni infection had axonal type of GBS (AMAN &AMSAN). Overall Axonal variety of GBS presented in a younger age group compared to AIDP (mean age- Axonal v/s AIDP- 30.11 + 13.73 v/s 40.2 + 18.77). C. jejuni positive patients presented mainly in spring and winter and had a similar age and sex incidence as compared to the rest of GBS patients. Conclusions: Preceding C. jejuni infection was more common among GBS patients than controls. Preceding C. jejuni infection in GBS patients was more commonly associated with the axonal variety of GBS. [ABSTRACT FROM AUTHOR]