Ümit GÖRGÜLÜ, Burak GEÇER, Şule BİLEN, Giray KOLCU

GUİLLAİN-BARRÉ SENDROMUNDA AĞIR ÖZÜRLÜLÜĞÜN ERKEN BELİRTEÇLERİ

Amaç Guillain-Barré sendromu (GBS), ihmal edilemez morbidite ve mortaliteye sahip otoimmün nörolojik bir hastalıktır. Bu çalışma, GBS hastalarında ağır engelliliğin erken belirteçleri olarak farklı hasta özelliklerini ve laboratuvar bulgularını değerlendirmeyi amaçladı. Gereç ve Yöntem 1 Ocak 2018 ile 31 Aralık 2021 tarihleri arasında GBS tanısı alan 121 hastanın tıbbi kayıtlarını retrospektif olarak inceledik. Demografik özellikler, başvuru şikayetleri, ek hastalıklar, geçirilmiş enfeksiyon öyküsü, nörolojik muayene bulguları, 1. gün ve 1. ay sonu GBS Disabilite Skorları (GDS), serolojik ve beyin omurilik sıvısı (BOS) incelemesi laboratuvar parametreleri, elektromiyonörografi sonuçları, GBS alt tipleri, tedaviler, tedaviye bağlı komplikasyonlar ve prognozlar kaydedildi. Bulgular 121 hastanın ortanca yaşı 58’di (20-87) (n = 73 erkek, %60). Ortalama GDS başvuruda 3 ve birinci ayın sonunda 2 idi. Serum C-reaktif protein (CRP) ve BOS protein seviyeleri yüksek, D vitamini seviyeleri düşüktü. İleri yaş, kraniyal sinir tutulumu, enfeksiyon öyküsü, yoğun bakım ünitesine (YBÜ) yatış, mekanik ventilasyon (MV) ihtiyacı, komplikasyon varlığı, yüksek plazma CRP düzeyleri, nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLO) GBS hastalarında 1. gün ve 1. ayın sonunda ciddi engellilik ile anlamlı şekilde ilişkiliydi. Sonuç GBS hastalarında ciddi engelliliği tahmin edebilecek çok sayıda özellik belirledik.

Anahtar Kelimeler:

Biyobelirteçler, Guillain-Barré disabilite skoru, Guillain-Barré sendromu, Hughes skoru, Özürlülük belirteçleri, Biomarkers, Guillain–Barré disability score, Guillain–Barré syndrome, Hughes score, Predictors of disability

EARLY PREDICTORS OF SEVERE DISABILITY IN GUILLAIN–BARRÉ SYNDROME

Objective Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder with non-negligible morbidity and mortality. This study aimed to evaluate different patient characteristics and laboratory findings as early predictors of severe disability in GBS patients. Material and Method We retrospectively reviewed the medical records of 121 patients diagnosed with GBS between January 1, 2018, and December 31, 2021. Data regarding demographic characteristics, presenting complaints, co-morbidities, previous infection history, neurological examination findings, GBS Disability Scores (GDS) on the 1st day and by the end of the first month, laboratory parameters of serological and cerebrospinal fluid (CSF) examination, electromyoneurography results, GBS subtypes, treatments, treatment-related complications, and prognoses were recorded. Results The median age of the 121 patients was 58 (20–87) years (n = 73 males, 60%). The average GDS was 3 on admission and 2 at the end of the first month. The serum C-reactive protein (CRP) and CSF protein levels were raised, while vitamin D levels were reduced. Advanced age, cranial nerve involvement, history of infection, admission to the intensive care unit (ICU), need for mechanical ventilation (MV), presence of complications, high plasma CRP levels, neutrophil-lymphocyte ratio (NLR), and plateletlymphocyte ratio (PLO) were significantly associated with severe disability in GBS patients at day 1 and at the end of the first month. Conclusion We identified multiple characteristics that can predict severe disability in GBS patients.

Keywords:

Biomarkers, Guillain–Barré disability score, Guillain–Barré syndrome, Hughes score, Predictors of disability,

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