Cytomegalovirus-related Guillain-Barre syndrome in an adult liver transplant recipient: a case report

Abstract

Guillain-Barré syndrome (GBS) is an immune-mediated condition affecting both the motor and sensory spinal roots and peripheric nerves. GBS is a rare entity, with its global incidence being as low as 0.81 to 1.89 cases per 100.000 person-year. Despite its low incidence, GBS have an important morbidity and lethal potential. This syndrome is usually triggered by infections. Due to its clinical presentation heterogeneity and its disease natural history, there is scarse availability of international clinical practice guidelines for the management of this entity. In this report, we present the case of a 67 years-old man on his fifth month after liver transplant (LT), who developed acute non-inflammatory diarrhea followed by sudden ascending symmetric paresia and soles paresthesias. Electrophysiologic studies reported a demyelinating inflammatory polyradiculoneuropathy compatible with GBS, acute severe inflammatory demyelinating polyneuropathy (AIDP) subtype. His neurology deficit was associated with a simultaneous primary Cytomegalovirus (CMV) infection, one of the most common GBS-related infectious agents.

Keywords

• guillain-barre syndrome
• liver transplantation
• cytomegalovirus
• immunosuppression.