Ban Mishu, MD; Amjad A. Ilyas, PhD; Carol L. Koski, MD; Francine Vriesendorp, MD; Stuart D. Cook, MD; Francis A. Mithen, MD, PhD; Martin J. Blaser, MD
To determine if patients with the Guillain-Barre syndrome are likely to have had Campylobacter jejuni infection before onset of neurologic symptoms.
A casecontrol study.
Several university medical centers.
Case patients met clinical criteria for the Guillain-Barre syndrome between 1983 and 1990 and had a serum sample collected and frozen within 3 weeks after onset of neurologic symptoms (n = 118). Disease controls were patients with other neurologic illnesses (n = 56); healthy controls were hospital employees or healthy family members of patients (n = 47).
Serum IgA, IgG, and IgM antibodies to C. jejuni were determined by enzyme-linked immunosorbent assays. Assays were done in a blinded manner.
Optical density ratios 2 in two or more immunoglobulin classes were seen in 43 (36%) of patients with the Guillain-Barre syndrome and in 10 (10%) of controls (odds ratio, 5.3; 95% CI, 2.4 to 12.5; P < 0.001). Increasing the optical density ratio or the number of immunoglobulin classes necessary to yield a positive result increased the strength of the association. The number of patients with the Guillain-Barre syndrome who had positive serologic responses was greatest from September to November (P = 0.02). Male patients were three times more likely to have serologic evidence of C. jejuni infection (P = 0.009); the proportion of patients with the syndrome who had a positive serologic response increased with age.
Patients with the Guillain-Barre syndrome are more likely than controls to have serologic evidence of C. jejuni infection in the weeks before onset of neurologic symptoms. Campylobacter jejuni may play a role in the initiation of the Guillain-Barre syndrome in many patients.
Mishu B, Ilyas AA, Koski CL, et al. Serologic Evidence of Previous Campylobacter jejuni Infection in Patients with the Guillain-Barre Syndrome. Ann Intern Med. 1993;118:947–953. doi: 10.7326/0003-4819-118-12-199306150-00006
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Published: Ann Intern Med. 1993;118(12):947-953.
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