Association between antecedent infection and albuminocytologic dissociation in cerebrospinal fluid of patients with Guillain-Barré syndrome

Abstract

Objective To analyze the albuminocytologic dissociation in cerebrospinal fluid （CSF） and differences in CSF protein levels in Guillain-Barré syndrome （GBS）patients with various types of antecedent infections and investigate the correlation between antecedent infections and increased CSF protein levels in GBS patients. Methods Clinical data and CSF analysis results of 198 GBS patients were collected. Enzyme-linked immunosorbent assay （ELISA） was employed to detect 14 types of infectious pathogens in the serum of GBS patients. The proportion of albuminocytologic dissociation and the differences in CSF protein levels were analyzed in GBS patients with different antecedent infections. Results In total，55.1% （109/198） of GBS patients had serological positivity for infectious pathogens，23.7% （47/198） for Campylobacter jejuni，20.7% （41/198） for Influenza A virus，15.2% （30/198） for Influenza B virus. Among them，18.7% （37/198） of GBS patients had serological positivity for two or more pathogens. In total，73.7% （146/198） of GBS patients had albuminocytologic dissociation in CSF. Among single pathogen-positive patients，83.3% （25/30） of Campylobacter jejuni positive patients showed albuminocytologic dissociation in CSF，100% （18/18） of Influenza A virus patients，6/7 of influenza B virus patients，4/5 of Hepatitis A virus patients，4/5 of Dengue virus patients，4/4 of Mycoplasma pneumoniae patients，1/1 of Epstein-Barr virus patients，1/1 of herpes simplex virus patients，and 1/1 of Varicella-zoster virus patients had albuminocytologic dissociation in CSF. Among patients infected with two or more pathogens，62.2% （23/37） showed albuminocytologic dissociation in CSF，while 66.3% （59/89） of GSB patients without antecedent infection had albuminocytologic dissociation in CSF. The positive rates of albuminocytologic dissociation in CSF exhibited significant differences among patients without and with various types of antecedent infections （P = 0.007），whereas no significant difference was noted in CSF protein levels （P > 0.05）. Conclusion The albuminocytologic dissociation in CSF of GBS patients is correlated with the type of antecedent infection. The highest proportion of albuminocytologic dissociation in CSF is observed in patients with Influenza A virus infections.

Keywords

• guillain-barré syndrome|antecedent infection|albuminocytologic dissociation in cerebrospinal fluid