Guillain-Barré syndrome after orthotopic liver transplantation: A clinical manifestation of immune reconstitution inflammatory syndrome?
- Authors: Lo Re, Vincenzina*; Petridis, Ioannis; Živković, Saša; Burgio, Gaetano; Mularoni, Alessandra; Milazzo, Mariapina; Sparacia, Gianvincenzo; Volpes, Riccardo; Luca, Angelo; Gruttadauria, Salvatore
- Publication year: 2018
- Type: Articolo in rivista (Articolo in rivista)
- Key words: Acute demyelinating polyneuropathy; Guillain-Barré syndrome; Immune reconstitution inflammatory syndrome; Liver transplantation; Tacrolimus; Surgery; Neurology (clinical)
- OA Link: http://hdl.handle.net/10447/318691
Abstract
Guillain-Barrè Syndrome, as part of the spectrum of dysimmune neuropathies, is unexpected to occur in immunocompromised hosts. We describe a clinical case of Guillain-Barrè syndrome, occurred a few weeks after a liver transplant, and we postulate that our case would satisfy all requirements to explain this peripheral nervous system complication as a clinical manifestation of an Immune reconstitution inflammatory syndrome. In this setting of liver transplantation, complicated by potentially multiple infective triggers, reduction of immunosuppression and reversal of pathogen-induced immunosuppression, through antimicrobial therapy, may have led to pro-inflammatory response. The pro-inflammatory pattern would have sustained the pathophysiologic mechanism of this immune neuropathy.