TITLE:
Clinically Diagnosed Guillain-Barre Syndrome in Pregnancy: Case Report and Review of Literature
AUTHORS:
Afolabi Korede Koledade, Adekunle O. Oguntayo, Sani A. Abubakar, Godfrey K. Katung, Sunday Oladapo Shittu
KEYWORDS:
Guillain-Barre Syndrome, Pregnancy, Immunoglobulin, Plasmapheresis
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.3 No.8,
August
14,
2014
ABSTRACT: Background: Guillain-Barre
syndrome (GBS) is an autoimmune disorder characterized by a heterogeneous group
of pathological and clinical entities. It is associated with ascending
areflexic paralysis, some autonomic dysfunction and respiratory failure in
severe cases and ultimately death if not promptly diagnosed and treated. It may
be preceded by an antecedent event in about two-third of cases. This could be
an upper respiratory tract infection, viral illness, recent history of
vaccination, pregnancy, cancer or even trauma. The condition is exceedingly rare
in pregnancy and only few cases have been reported in literature. Case Report: This
is a case of a 28-year-old Gravida 3, Para 1+1 and Estimated
Gestational Age of 30 weeks and 4 days. There was a history of upper
respiratory tract infection eight weeks prior to presentation which
spontaneously resolved. On examination, she was a young woman, anxious, weak,
afebrile, not pale, the neck could not hold the head upright and there was
bilateral non tender pitting pedal oedema extending to her mid-shin. There
were no cranial nerve deficits and no sign of meningeal irritation. There were
normal muscle bulk with global hypotonia and flaccid quadriparesis, Power was
3/5. The proximal groups of muscles were more affected than the distal parts.
Reflexes were diminished globally with plantar flexor response. She had
immunoglobulin as treatment. Conclusion: In a low resource setting like ours it
is important to have a high index of suspicion of GBS when an apparently
healthy gravid woman presents with progressive weakness of the limbs.