¨A síndrome de Guillain-Barré (SGB) é uma polirradiculoneuropatia inflamatória monofásica de caráter autoimune, caracterizada por rápida evolução ascendente de fraqueza de membros, quase sempre simétrica, hipo ou arreflexia e dissociação celuloproteica no líquido cefalorraquidiano (LCR). A doença pode chegar à máxima gravidade em até quatro semanas, com o desenvolvimento de insuficiência respiratória em aproximadamente 25% dos casos. Destes, a maioria tem completa recuperação. Entretanto, podem ocorrer sequelas graves e óbitos em até 20% e 5% dos casos, respectivamente. Após a eliminação da poliomielite, a SGB tornou-se a maior causa de paralisia flácida no mundo, representando um grave problema de Saúde Pública cuja incidência pode variar de 0,4 a 4 casos/100 mil habitantes em diferentes regiões do mundo. O envolvimento autonômico pode der proeminente. Frequentemente, a SGB é precedida por uma infecção. Há também relatos de SGB após vacinação ou trauma, como cirurgias, embora ambas as situações sejam consideradas raras e discutíveis. O agente mais comumente associado à infecção anterior é a bactéria Campylobacter jejuni, seguida de infecções por citomegalovírus, vírus Epstein-Barr (EBV), Mycoplasma pneumoniae, Haemophilus influenzae, vírus da influenza A, hepatite B e E, e vírus da imunodeficiência humana (HIV). Atualmente, também há registros de casos de SGB associados a infecções pelos vírus da dengue, chikungunya e Zika. O diagnóstico da SGB é feito de acordo com a apresentação clínica, resultados de eletroneuromiografia e características do líquido cefalorraquidiano. O líquido cefaloraquidiano de pacientes com SGB tem elevado conteúdo de proteínas, porém contagens celulares baixas (normais). Além do suporte clínico, o tratamento se baseia em imunoterapia por imunoglobulina intravenosa (IgIV) ou plasmaférese. A função pulmonar é monitorada cuidadosamente, com entubação em caso de insuficiência respiratória iminente. ¨
■ Surto de síndrome de Guillain-Barré possivelmente relacionado à infecção prévia pelo vírus Zika, Região Metropolitana do Recife, Pernambuco, Brasil, 2015
Nóbrega, Martha Elizabeth Brasil da et al.
Epidemiol. Serv. Saúde, 2018, vol.27, no.2
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-96222018000200309&lng=pt&nrm=iso
■ The efficacy of intravenous immunoglobulin in Guillain-Barré syndrome: The experience of a tertiary Medical Center
D Shalem, A Shemer, O Shovman et al
Israel Med Assoc J 2018, vol 20 (12): 754-760
https://www.ima.org.il/FilesUpload/IMAJ/0/318/159096.pdf
■ Prevalence of Guillain-Barré syndrome among Zika virus infected cases: a systematic review and meta-analysis
Barbi, Ludovica et al.
Braz J Infect Dis, Mar 2018, vol.22, no.2, p.137-141
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000200137&lng=pt&nrm=iso
■ Incidence of Guillain-Barré syndrome among Zika virus infected cases: a report from Thailand
Joob, Beuy and Wiwanitkit, Viroj
Arq. Neuro-Psiquiatr., Jan 2018, vol.76, no.1, p.63-63
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2018000100063&lng=pt&nrm=iso
■ Electrophysiological subtypes and prognostic factors of childhood Guillain-Barré syndrome
Bahadır Konuşkan, Çetin Okuyaz, Bahar Taşdelen et al
Turkish Childhood Guillan-Barre Syndrome Study Group
Noro Psikiyatr Ars. 2018 Sep; 55(3): 199–204
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138236/
■ Effect of serum inflammatory markers on the prognosis of adult and pediatric patients with Guillain-Barré syndrome
Ozlem Ethemoglu, Mustafa Calik
Neuropsychiatr Dis Treat. 2018; 14: 1255–1260
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960237/
■ Zika vírus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: from systematic review to living systematic review
Counotte MJ, Egli-Gany D, Riesen M, Abraha M, Porgo TV, Wang J, Low N.
F1000Res. 2018 Feb 15;7:196
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290976/
■ Leptospirosis complicated with Guillain Barre syndrome, papillitis and thrombotic thrombocytopenic púrpura: a case report
Kobawaka Gamage KK, Fernando H.
BMC Infect Dis. 2018 Dec 22;18(1):691
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303948/
■ Reversible conduction failure on the deep tendon reflex response recording in early Guillain-Barré syndrome
García A, Sedano MJ, Álvarez-Paradelo S, Berciano J.
Clin Neurophysiol Pract. 2018 Nov 3;3:159-163
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247394/
■ Dengue fever complicated with Guillainn-Barré syndrome: a case report and review of the literature
Chamara Dalugama, John Shelton, Mahendra Ekanayake, Indika Bandara Gawarammana
J Med Case Rep. 2018; 12: 137
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952700/
■ Guillain-Barré syndrome
F F M Wijdicks, C J Klein
Mayo Clinic Proceedings 2017, vol 92 (3): 467-479
https://www.mayoclinicproceedings.org/article/S0025-6196(16)30818-7/fulltext
■ Guillain-Barré syndrome and Chikungunya: description of all cases diagnosed during the 2014 outbreak in the French West Indies
Stephanie Balavoine, Mathilde Pircher, Bruno Hoen et al
Am J Trop Med Hyg. 2017 Aug 2; 97(2): 356–360
■ Guillain-Barré syndrome risk among individuals infected with Zika virus: a multi-country assessment
Luis Mier-y-Teran-Romero, Mark J. Delorey, James J. Sejvar, Michael A. Johansson
BMC Med. 2018; 16: 67
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952697/
■ Postmortem in patient with Guillain-Barré syndrome and Zika virus infection
Emilio Dirlikov, José V. Torres, Roosecelis Brasil Martines et AL
Emerg Infect Dis. 2018 Jan; 24(1): 114–117
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749436/
■ Inspiratory muscle training with isokinetic device to help ventilator weaning in a patient with Guillain-Barré syndrome by Zika virus
Cordeiro de Souza L, de Souza AA, de Almeida EEP et al
Case Rep Crit Care. 2018 Oct 4;2018:9708451
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193329/
■ Increased of Guillain-Barré syndrome associated with Zika virus outbreak in the Salvador metropolitan area, Brazil
Ashley R. Styczynski, Juliane M. A. S. Malta, Elisabeth R. Krow-Lucal et al
PLoS Negl Trop Dis. 2017 Aug; 11(8): e000586
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5595339/
■ Biological drugs in Guillain-Barré syndrome: an update
Nazgol Motamed-Gorji, Nassim Matin, Omidreza Tabatabaie et al
Curr Neuropharmacol. 2017 Oct; 15(7): 938–950
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652014/
■ Síndrome de Guillain-Barré e outras manifestações neurológicas possivelmente relacionadas à infecção pelo vírus Zika em municípios da Bahia, 2015
Malta, Juliane Maria Alves Siqueira et al.
Epidemiol. Serv. Saúde, Mar 2017, vol.26, no.1, p.9-18
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-96222017000100009&lng=pt&nrm=iso
■ Guillain-Barré syndrome: celebrating a century.
Freitas, Marcos R. G. de, Vidal, Cecília M. and Orsini, Marco
Arq. Neuro-Psiquiatr., Aug 2017, vol.75, no.8, p.600-60
■ Polyspecific antibodies without persisting antigen in multiple sclerosis, neurolupus and Guillain-Barré syndrome: immune network connectivity in chronic diseases
Reiber, Hansotto.
Arq. Neuro-Psiquiatr., Aug 2017, vol.75, no.8, p.580-588
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000800580&lng=pt&nrm=iso
■ The many faces of demyelinating diseases: acute disseminated encephalomyelitis and Guillain-Barré syndrome in the same patient
Trindade, Régis Augusto Reis, Klaes, Amália Izaura Nair Medeiros and Duarte, Juliana Ávila
Arq. Neuro-Psiquiatr., May 2017, vol.75, no.5, p.324-325
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2017000500324&lng=pt&nrm=iso
■ Epidemiology of Guillain-Barré syndrome in Finland 2004-2014
Jussi O.T. Sipilä, Merja Soilu‐Hänninen, Jori O. Ruuskanen, Päivi Rautava, Ville Kytö
J Peripher Nerv Syst. 2017 Dec; 22(4): 440–445.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5765466/
■ Tracheostomy or not: prediction of prolonged mechanical ventilation in Guillain-Barré syndrome
Christa Walgaard, Hester F. Lingsma, Pieter A. van Doorn et al
Neurocrit Care. 2017; 26(1): 6–13
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227005/
■ Guillain-Barré syndrome presenting with sinus node dysfuncion and refractory shock
Le Dung Ha, Farrukh Abbas, Mohan Rao
Am J Case Rep. 2017; 18: 251–254
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358838/
■ Guillain-Barré syndrome: a variant consisting of facial diplegia and paresthesia with left facial hemiplegia associated with antibodies to galctocerebroside and phosphatidic acid
Sho Nishiguchi, Joel Branch, Tsubasa Tsuchiya, Ryoji Ito, Junya Kawada
Am J Case Rep. 2017; 18: 1048–1052
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633102/
■ Are cerebrospinal fluid protein levels and plasma neutrophil/Lymphocyte ratio associated with prognosis of Guillain Barré syndrome?
Sevki Sahin, Nilgun Cinar, Sibel Karsidag
Neurol Int. 2017 Jun 23; 9(2): 7032
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505084/
■ Guillain-Barré syndrome presenting with sinus node dysfunction and refractory shock
Le Dung Ha, Farrukh Abbas, Mohan Rao
Am J Case Rep. 2017; 18: 251–254
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358838/
■ Clinical and electrophysiological features of post-traumatic Guillain-Barré syndrome
Xiaowen Li, Jinting Xiao, Yanan Ding et al
BMC Neurol. 2017; 17: 142
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531106/
■ Síndrome de Guillain-Barré em paciente pediátrico: relato de caso e revisão da literatura
L S Maranho, G W Ribas, M Bandeira
Revista Médica da UFPR 2016, vol 3 (1): 41-44
https://revistas.ufpr.br/revmedicaufpr/article/view/44634/pdf
■ Guillain-Barré syndrome and Hashimoto´s thyroiditis
M T Daouda, N S Obenda, L Maazou et al
QJM: An International Journal of Medicine 2016, vol 109 (8): 547-548
https://academic.oup.com/qjmed/article/109/8/547/1752915/Guillain-Barre-syndrome-and-Hashimoto-s
■ Outcome of Guillain-Barré syndrome patients with respiratory paralysis
J Kalita, A Ranjan, U K Misra
QJM: An International Journal of Medicine 2016, vol 109 (5): 319-323
■ Guillain-Barré syndrome
H J Willison, B C Jacobs, P A van Doorn
The Lancet 2016, vol 388: p717-727
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00339-1/fulltext
■ Síndrome de Guillain-Barré em paciente pediátrico: relato de caso e revisão da literatura
L S Maranho, G W Ribas, M Bandeira
Revista Médica da UFPR 2016, vol 3 (1): 41-44
https://revistas.ufpr.br/revmedicaufpr/article/view/44634/pdf
■ Guillain-Barré syndrome (42 cases) occurring during a Zika vírus outbreak in French Polynesia
Louise Watrin, Frédéric Ghawché, Philippe Larre et al
Medicine (Baltimore) 2016 Apr; 95(14): e3257
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998790/
■ Guillain-Barré syndrome following the 2009 pandemic monovalent and seasonal trivalent influenza vaccination campaigns in Spain from 2009 to 2011: outcomes from active surveillance by a neurologist network, and records from a country-wide hospital discharge database
Enrique Alcalde-Cabero, Javier Almazán-Isla, Fernando J. García López et al
Spanish GBS Epidemiology Study Group
BMC Neurol. 2016; 16: 75.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875759/
■ Long-term impact after fulminant Guillain-Barré, case report and literature review
Alain Rougé, Jérémie Lemarié, Sébastien Gibot, Pierre Edouard Bollaert
Int Med Case Rep J. 2016; 9: 357–363
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106230/
■ Guillain-Barré syndrome in general practice: clinical features suggestive of early diagnosis
Virginia A Head, Benjamin R Wakerley
Br J Gen Pract. 2016 Apr; 66(645): 218–21
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809704/
■ Guillain-Barre syndrome as a differential diagnosis of low back pain syndrome
Jiménez Avila, José María et al
Columna, Sept 2016, vol.15, no.3, p.244-247
■ Guillain-Barré syndrome and dengue fever: report on ten new cases in Brazil
Fragoso, Yara Dadalti et al.
Arq. Neuro-Psiquiatr., Dec 2016, vol.74, no.12, p.1039-1040
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2016001201039&lng=pt&nrm=iso
■ Analysis of the albumin level, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in Guillain-Barré syndrome
Ozdemir, Hasan Huseyin.
Arq. Neuro-Psiquiatr., Sept 2016, vol.74, no.9, p.718-722
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2016000900718&lng=pt&nrm=iso
■ Guillain-Barré syndrome and Zika virus infection.
Wiwanitkit, Viroj.
Arq. Neuro-Psiquiatr., Aug 2016, vol.74, no.8, p.692-692
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2016000800692&lng=pt&nrm=iso
■ Guillain-Barré syndrome associated with the Zika virus outbreak in Brazil
Araujo, Lucas Masiêro, Ferreira, Maria Lucia Brito and Nascimento, Osvaldo JM
Arq. Neuro-Psiquiatr., Mar 2016, vol.74, no.3, p.253-255
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2016000300013&lng=pt&nrm=iso
■ Revisão da literature: a relação entre Zika vírus e síndrome de Guillain-Barré
J I G Chaves Filho, I L A Reis, A S França, D C B Cortela
Revista Ciência e Estudos Acadêmicos de Medicina 2016, vol 5: 22-29
https://periodicos.unemat.br/index.php/revistamedicina/article/view/1365/1402
■ Síndrome de Guillain-Barré recorrente: caso clínico
M J P Silva, J R de Carvalho, J Carvalho et al
SPMFR Journl 2015, vol 27 (2)
https://spmfrjournal.org/index.php/spmfr/article/view/202
■ Is a second cycle of immunoglobulin justified in axonal forms of Guillain-Barré syndrome?
Godoy, Daniel Agustin and Rabinstein, Alejandro
Arq. Neuro-Psiquiatr., Oct 2015, vol.73, no.10, p.848-85
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2015001000848&lng=pt&nrm=iso
■ Cumulative risk of Guillain-Barré syndrome among vaccinated and unvaccinated populations during the 2009 H1N1 influenza pandemic
Claudia Vellozzi, Shahed Iqbal, Brock Stewart et al
Am J Public Health. 2014 Apr; 104(4): 696–701
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025712/
■ Syndrome of inappropriate antidiuretic hormone secretion related to Guillain-Barré syndrome after laparoscopic cholecystectomy
Çakirgöz, Mensure Yilmaz et al
Rev. Bras. Anestesiol., June 2014, vol.64, no.3, p.195-198
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000300195&lng=pt&nrm=iso
■ Risk of Guillain-Barré syndrome following pandemic influenza A (H1N1) 2009 vaccination in Germany
Jürgen Prestel, Peter Volkers, Dirk Mentzer, Helmar C Lehmann, Hans-Peter Hartung, Brigitte Keller-Stanislawski
Pharmacoepidemiol Drug Saf. 2014 Nov; 23(11): 1192–1204
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282476/
■ Anesthesia for cesarean section in pregnant woman with Guillain Barré syndrome: a case report
Queiroz, Thiago Nobre et al.
Rev. Bras. Anestesiol., Oct 2014, vol.64, no.5, p.369-372
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000500369&lng=pt&nrm=iso
■ An update in Guillian-Barré syndrome
- B. Winer
Autoimmune Dis. 2014; 2014: 793024
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910670/
■ Guillain-Barré syndrome
A D Walling, G Dickson
Am Fam Physician 2013, vol 87 (3): 191-197
https://www.aafp.org/afp/2013/0201/p191.html
■ Assessment of autonomic dysfunction in childhood Guillain-Barré syndrome
Mahmood Samadi, Babak Kazemi, Sona Golzari Oskoui, Mohammad Barzegar
J Cardiovasc Thorac Res. 2013; 5(3): 81–85
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825393/
■ Risk of Guillain-Barré syndrome after 2010-2011 influenza vaccination
Francesca Galeotti, Marco Massari, Roberto D’Alessandro et AL
The ITANG study group
Eur J Epidemiol. 2013 May; 28(5): 433–444
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672511/
■ Guillain-Barré syndrome: natural history and prognostic factors: a retrospective review of 106 cases
I González-Suárez, I Sanz-Gallego, F J R de Rivera, J Arpa
BMC Neurol 2013, vol 13: 95
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3723666/
■ Guillain-Barré syndrome and variants
Mazen M. Dimachkie, Richard J. Barohn
Neurol Clin. 2013 May; 31(2): 491–510
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939842/
■ Role of Campylobacter jejuni infection in the pathogenesis of Guillain-Barré syndrome: an update
Kishan Kumar Nyati, Roopanshi Nyati
Biomed Res Int. 2013; 2013: 852195
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755430/
■ Reversible focal encephalic abnormalities in a patient with Guillain-Barré syndrome
Cruto, Catarina A., Pinto, Nuno Cardoso and Pato, Maria Vaz
Arq. Neuro-Psiquiatr., June 2012, vol.70, no.6, p.471-472
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2012000600017&lng=pt&nrm=iso
■ Guillain-Barré syndrome in children: clinic, laboratorial and epidemiologic study of 61 patients
Linden, Vanessa van der et al.
Arq. Neuro-Psiquiatr., Feb 2010, vol.68, no.1, p.12-17
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2010000100004&lng=pt&nrm=iso
by Dr Paulo Fernando Leite
Médico Cooperado Unimed BH – CRMMG: 7026
Belo Horizonte/Minas Gerais/Brasil
Email: pfleite1873@gmail.com