Simultaneous occurrence of axonal Guillain–Barré syndrome in two siblings following dengue infection

Abstract

Guillain–Barré syndrome (GBS) is an infrequent neurological complication of dengue viral infection. It is broadly divided into either acute inflammatory demyelinating variety or an axonal variety (acute motor axonal and acute sensory and motor axonal variants). Axonal variants are distinctly infrequent. Two brothers (18 years and 15 years) were hospitalized on the same day with complaints of acute symmetric upper- and lower-limb weakness of 7 days' duration. They did not have overt manifestations of dengue fever which preceded the neurological presentation. They had flaccid areflexic pure motor quadriparesis. Dengue IgM serology was positive in both. Nerve conduction study showed predominant axonopathic changes in both the patients. Both the patients showed significant improvement with conservative treatment during hospital stay of 7 days. This is unusual report of dengue-associated axonal GBS in two brothers. Whether simultaneous occurrence of GBS in two siblings is a coincidence or genetically determined is still a question.

Keywords

• Autoimmune
• dengue virus
• genetic susceptibility
• Guillain–Barré syndrome