19. Severe prognostic factors in children with Guillain – Barre syndrome
Main Article Content
Abstract
We conducted a survey research on 127 children with Guillain - Barre syndrome at the National Children's Hospital from 7/2018 to 6/2023 to investigate severe prognosis factors associated with this condition. The mean age was 6.14 ± 0.37 years old (16 months - 16 years old), male/female ratio was 2.1/1. There were 13 patients in the severe group requiring mechanical ventilation, including 1 death (0.8%). 62.2% had pre - infectious factors, common were fever 36.2%, respiratory infections 31.1%, digestive disorders 7.1%. Cytoalbuminologic dissociation was found in 72% of patients, 2 common types of electromyography were demyelination and axonal degeneration for 31.7% and 41.3%. Prognosis of severe disease were pre - infection with fever, short day of presentation, oropharyngeal weakness at onset, low muscle strength score at admission, autonomic dysfunction, cranial nerve palsy, respiratory failure, fever during treatment, increased leucocyte count, increased C - reactive protein and increased neutrophil lymphocyte ratio. Clinical symptoms of Guillain - Barre syndrome in children are various and atypical thus it is necessary to combine clinical and laboratory studies to fully evaluate the severe prognostic factors of the disease. Peripheral blood count and C - reactive protein testing should be indicated in patients with clinical findings suggestive of severe disease.
Methods: A survey research on 127 children with Guillain - Barre syndrome at the National Children's Hospital from 7/2018 to 6/2023.
Results: Analysis of a total of 127 children, the male/female ratio was 2.1/1, the mean age was 6.14 ± 0.37 years old (16 months - 16 years old). 62.2% had antecedent illness, common were respiratory infections 31.1%, fever 36.2%, digestive disorders 7.1%. There are 13/127 patients in the severe group (Hughes >4 points) requiring mechanical ventilation, including 1 death (0.8%). Some factors related to the prognosis of severe disease: pre - infection with fever (p = 0.015), short day of presentation (p = 0.0001), oropharyngeal weakness at onset (p = 0.013), low MRC score at admission (p = 0.003), autonomic dysfunction (p = 0.0001), cranial nerve palsy (p = 0.026), respiratory failure ( p = 0.0001), fever during treatment (p = 0.0001), increased leucocyte count (p = 0.008), increased CRP (C - reactive protein) (p = 0.004), increased NLR (Neutrophil lymphocyte ratio) (p = 0.009).
Conclusions: Clinical symptoms of Guillain - Barre syndrome in children are various and atypical. Prognostic factors for severe disease include pre - infection with fever, short time of presentation, oropharyngeal weakness at onset, low MRC score at admission, autonomic dysfunction, cranial nerve palsy, respiratory failure and fever during treatment, increased leukocytes count, increased CRP and increased NLR. It is necessary to combine clinical and laboratory studies to fully evaluate the severe prognostic factors of the disease. Peripheral blood count and CRP testing should be indicated in patients with clinical findings suggestive of severe disease.
Article Details
Keywords
Guillain - Barre syndrome, children, prognostic
References
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