Infections and vaccinations preceding childhood Guillain-Barré syndrome: a prospective study

Zeitschrift für Kinderheilkunde - Tập 165 - Trang 605-612 - 2006
Joachim Schessl1, Birgit Luther2, Janbernd Kirschner1, Gottfried Mauff3, Rudolf Korinthenberg1
1Division of Neuropaediatrics and Muscular Disorders, Department of Paediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany
2Department of Clinical Microbiology and Hygiene, Institute of Hygiene and Environment, Hamburg, Germany
3Laboratory Dr. Kramer and Colleagues, Geesthacht, Germany

Tóm tắt

We performed a prospective, multicentre study in children with Guillain-Barré syndrome (GBS), diagnosed according to international criteria, to investigate the frequency and aetiology of antecedent diseases. All infections and vaccinations occurring within a 6-week period prior to the onset of GBS were documented. Stool cultures, standardised serological investigations and PCR analyses for 24 different infective agents were performed. Serological findings were regarded as significant if specific immunoglobulin (Ig)M or IgA antibodies were detected, if the IgM enzyme immunoassay or immunfluorescence assay findings were confirmed by immunoblot, if complement fixation test titres rose fourfold or if geometric titres were more than threefold higher than in uninfected control persons. Ninety-five children with GBS were included in the study over a 40-month period. Preceding events were reported in 82%. Microbiological studies carried out on 84 patients resulted in a probable diagnosis in 46 (55%). Coxsackieviruses (15%), Chlamydia pneumoniae (8%), cytomegalovirus (7%) and Mycoplasma pneumoniae (7%) were the most frequently involved agents. Serological evidence of a Campylobacter jejuni infection was found in six patients (7%). Eight children had been vaccinated during the 6 weeks preceding the onset of GBS; in six of these children concomitant infectious diseases were reported, and in one child the time between vaccination and GBS was extremely short. We conclude that, in contrast to adults, Campylobacter spp. does not seem to play a major role in childhood GBS in German-speaking countries. The aetiology of antecedent diseases is distributed over a wide spectrum of paediatric infectious diseases. Most of the children who had been vaccinated showed concomitant infectious diseases, thus obscuring the causative role for GBS.

Tài liệu tham khảo

Aldous MB, Grayston JT, Wang SP, Foy HM (1992) Seroepidemiology of Chlamydia pneumoniae TWAR infection in Seattle families, 1966–1979. J Infect Dis 166:646–649 Ang CW, Jacobs BC, Brandenburg AH, Laman JD, van der Meche FG, Osterhaus AD, van Doorn PA (2000) Cross-reactive antibodies against GM2 and CMV-infected fibroblasts in Guillain-Barre syndrome. Neurology 54:1453–1458 Asbury AK (2000) New concepts of Guillain-Barre syndrome. J Child Neurol 15:183–191 Asbury AK, Cornblath DR (1990) Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 27[Suppl]:S21–S24 Baer W, Fricke G, Goossens H (1989) Distribution of serotypes and biotypes of thermophilic campylobacters in the Federal Republic of Germany: a comparison with other countries. Zentralbl Bakteriol 271:127–134 Blaser MJ, Duncan DJ (1984) Human serum antibody response to Campylobacter jejuni infection as measured in an enzyme-linked immunosorbent assay. Infect Immun 44:292–298 Dal Molin G, Longo B, Not T, Poli A, Campello C (2005) A population based seroepidemiological survey of Chlamydia pneumoniae infections in schoolchildren. J Clin Pathol 58:617–620 da Silveira CM, Salisbury DM, de Quadros CA (1997) Measles vaccination and Guillain-Barre syndrome. Lancet 349:14–16 Enders U, Karch H, Toyka KV, Michels M, Zielasek J, Pette M, Heesemann J, Hartung HP (1993) The spectrum of immune responses to Campylobacter jejuni and glycoconjugates in Guillain-Barre syndrome and in other neuroimmunological disorders. Ann Neurol 34:136–144 Foy HM, Kenny GE, Cooney MK, Allan ID (1979) Long-term epidemiology of infections with Mycoplasma pneumoniae. J Infect Dis 139:681–687 Goddard EA, Lastovica AJ, Argent AC (1997) Campylobacter 0:41 isolation in Guillain-Barre syndrome. Arch Dis Child 76:526–528 Godschalk PC, Heikema AP, Gilbert M, Komagamine T, Ang CW, Glerum J, Brochu D, Li J, Yuki N, Jacobs BC, van Belkum A, Endtz HP (2004) The crucial role of Campylobacter jejuni genes in anti-ganglioside antibody induction in Guillain-Barre syndrome. J Clin Invest 114:1659–1665 Gruenewald R, Ropper AH, Lior H, Chan J, Lee R, Molinaro VS (1991) Serologic evidence of Campylobacter jejuni/coli enteritis in patients with Guillain-Barre syndrome. Arch Neurol 48:1080–1082 Hadden RD, Karch H, Hartung HP, Zielasek J, Weissbrich B, Schubert J, Weishaupt A, Cornblath DR, Swan AV, Hughes RAC, Toyka KV, Plasma/Exchange Guillain Barré Syndrome Trial Group (2001) Preceding infections, immune factors, and outcome in Guillain-Barre syndrome. Neurology 56:758–765 Hahn AF (1998) Guillain-Barre syndrome. Lancet 352:635–641 Hughes RAC (1990) Guillain-Barre syndrome. Springer, Berlin Heidelberg New York Hughes R, Rees J, Smeeton N, Winer J (1996) Vaccines and Guillain-Barre syndrome. Br Med J 312:1475–1476 Hung KL, Wang HS, Liou WY, Mak SC, Chi CS, Shen EY, Lin MI, Wang PJ, Shen YZ, Chang KP (1994) Guillain-Barre syndrome in children: a cooperative study in Taiwan. Brain Dev 16:204–208 Ismail EA, Shabani IS, Badawi M, Sanaa H, Madi S, Al-Tawari A, Nadi H, Zaki M, Al-saleh Q (1998) An epidemiologic, clinical, and therapeutic study of childhood Guillain-Barre syndrome in Kuwait: is it related to the oral polio vaccine? J Child Neurol 13:488–492 Jacobs BC, Rothbarth PH, van der Meche F, Herbrink P, Schmitz PI, de Klerk MA, van Doorn PA (1998) The spectrum of antecedent infections in Guillain-Barre syndrome: a case-control study. Neurology 51:1110–1115 Kendall EJ, Tanner EI (1982) Campylobacter enteritis in general practice. J Hyg (London) 88:155–163 Kinnunen E, Farkkila M, Hovi T, Juntunen J, Weckstrom P (1989) Incidence of Guillain-Barre syndrome during a nationwide oral poliovirus vaccine campaign. Neurology 39:1034–1036 Kogon A, Spigland I, Frothingham TE, Elveback L, Williams C, Hall CE, Fox JP (1969) The virus watch program: a continuing surveillance of viral infections in metropolitan New York families. VII. Observations on viral excretion, seroimmunity, intrafamilial spread and illness association in coxsackie and echovirus infections. Am J Epidemiol 89:51–61 Korinthenberg R, Schulte Moenting JS (1996) Natural history and treatment effects in Guillain-Barre syndrome: a multicentre study. Arch Dis Child 74:281–287 Lasky T, Terracciano GJ, Magder L, Koski CL, Ballesteros M, Nash D, Clark S, Haber P, Stolley PD, Schonberger LB, Chen RT (1998) The Guillain-Barre syndrome and the 1992–1993 and 1993–1994 influenza vaccines. N Engl J Med 339: 1797–1802 Liu GF, Wu ZL, Wu HS, Wang QY, Zhao-Ri GT, Wang CY, Liang ZX, Cui SL, Zheng JD (2003) A case-control study on children with Guillain-Barre syndrome in North China. Biomed Environ Sci 16: 105-111 Mauch H, Lütticken R, Gatermann S (2000) MIQ. German quality standards in microbiology – Qualitätsstandards in der mikrobiologisch-serologischen Diagnostik. Infektionen des Darmes. Urban & Fischer, München, Jena Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV (1999) Food-related illness and death in the United States. Emerg Infect Dis 5:607–625 Monto AS, Bryan ER, Rhodes LM (1974) The Tecumseh study of respiratory illness. VII. Further observations on the occurrence of respiratory syncytial virus and Mycoplasma pneumoniae infections. Am J Epidemiol 100:458–468 Mori M, Kuwabara S, Miyake M, Noda M, Kuroki H, Kanno H, Ogawara K, Hattori T (2000) Haemophilus influenzae infection and Guillain-Barre syndrome. Brain 123:2171–2178 Nachamkin I, Allos BM, Ho TW (2000) Campylobacter jejunI infection and association with Guillain-Barré syndrome. In: Nachamkin I, Blaser MJ (eds) Campylobacter, 2nd edn. ASM Press,Washington D.C. Nachamkin I, Liu J, Li M, Ung H, Moran AP, Prendergast MM, Sheikh K (2002) Campylobacter jejuni from patients with Guillain-Barre syndrome preferentially expresses a GD(1a)-like epitope. Infect Immun 70:5299–5303 Ogawara K, Kuwabara S, Mori M, Hattori T, Koga M, Yuki N (2000) Axonal Guillain-Barre syndrome: relation to anti-ganglioside antibodies and Campylobacter jejuni infection in Japan. Ann Neurol 48:624–631 Patja A, Paunio M, Kinnunen E, Junttila O, Hovi T, Peltola H (2001) Risk of Guillain-Barre syndrome after measles-mumps-rubella vaccination. J Pediatr 138:250–254 Prendergast MM, Lastovica AJ, Moran AP (1998) Lipopolysaccharides from Campylobacter jejuni O:41 strains associated with Guillain-Barre syndrome exhibit mimicry of GM1 ganglioside. Infect Immun 66:3649–3655 Rantala H, Cherry JD, Shields WD, Uhari M (1994) Epidemiology of Guillain-Barre syndrome in children: relationship of oral polio vaccine administration to occurrence. J Pediatr 124:220–223 Rees JH, Soudain SE, Gregson NA, Hughes RA (1995) Campylobacter jejuni infection and Guillain-Barre syndrome. N Engl J Med 333:1374–1379 Rose NR, Hamilton RG, Detrick B (2002) Manual of clinical laboratory immunology, 6th edn. ASM Press, Washington D.C. Safranek TJ, Lawrence DN, Kurland LT, Culver DH, Wiederholt WC, Hayner NS, Osterholm MT, O’Brien P, Hughes JM (1991) Reassessment of the association between Guillain-Barre syndrome and receipt of swine influenza vaccine in 1976–1977: results of a two-state study. Expert Neurology Group. Am J Epidemiol 133:940–951 Stratton KR, Howe CH Johnston RB (1994) Adverse events associated with childhood vaccines. Evidence bearing on causality. National Academy Press, Washington D.C., pp 19–33 Uhari M, Rantala H, Niemela M (1989) Cluster of childhood Guillain-Barre cases after an oral poliovaccine campaign. Lancet 2:440–441 Winer JB (2001) Guillain Barre syndrome. Mol Pathol 54:381–385 Winer JB, Hughes RA, Anderson MJ, Jones DM, Kangro H, Watkins RP (1988) A prospective study of acute idiopathic neuropathy. II. Antecedent events. J Neurol Neurosurg Psychiatry 51:613–618 Yow MD, White NH, Taber LH, Frank AL, Gruber WC, May RA, Norton HJ (1987) Acquisition of cytomegalovirus infection from birth to 10 years: a longitudinal serologic study. J Pediatr 110:37–42