Guillain-Barré syndrome in children – High occurrence of Miller Fisher syndrome in East Asian region

Guillain-Barré syndrome (GBS) is a rare acquired immune-mediated polyneuropathy. Updated population-based data concerning paediatric GBS is needed. Paediatric patients aged below 18 years diagnosed with GBS between 2009 and 2018 in all 11 paediatric departments in Hong Kong were identified from the...

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Published in:Brain & development (Tokyo. 1979) 2022-11, Vol.44 (10), p.715-724
Main Authors: Chiu, Annie Ting Gee, Chan, Ricky Wing Ki, Yau, Maggie Lo Yee, Yuen, Angus Chi Lap, Lam, Alva King Fai, Lau, Shirley Wai Yin, Lau, Alan Ming Chung, Fung, Sharon Tsui Hang, Ma, Kam Hung, Lau, Christine Wai Ling, Yau, Man Mut, Ko, Chun Hung, Tsui, Kwing Wan, Ma, Che Kwan, Tai, Shuk Mui, Yau, Eric Kin Cheong, Fung, Eva, Wu, Shun Ping, Kwong, Karen Ling, Chan, Sophelia Hoi Shan
Format: Article
Language:English
Subjects:
Acute inflammatory demyelinating polyneuropathy
Acute motor axonal neuropathy
Acute motor sensory axonal neuropathy
Children
Guillain-Barré syndrome
Miller Fisher syndrome
Paediatric
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Summary:Guillain-Barré syndrome (GBS) is a rare acquired immune-mediated polyneuropathy. Updated population-based data concerning paediatric GBS is needed. Paediatric patients aged below 18 years diagnosed with GBS between 2009 and 2018 in all 11 paediatric departments in Hong Kong were identified from the Hong Kong Hospital Authority Clinical Data Analysis and Reporting System. The collected data from medical health records were reviewed by paediatric neurologist from each department. Estimated incidence of paediatric GBS was calculated. We also compared our findings with other paediatric GBS studies in Asia. 63 subjects of paediatric GBS were identified, giving an estimated annual incidence of 0.62 per 100,000 population. Half of the subjects had acute inflammatory demyelinating polyneuropathy (AIDP) (n = 31; 49.2%), one quarter had Miller Fisher Syndrome (MFS) (n = 16; 25.4%), one-fifth had axonal types of GBS (n = 12; 19.0%), and four were unclassified. Paediatric subjects with axonal subtypes of GBS compared to the other 2 subtypes, had significantly higher intensive care unit (ICU) admission rates (p = 0.001) and longest length of stay (p = 0.009). With immunomodulating therapy, complete recovery was highest in those with MFS (100%), followed by AIDP (87.1%) and axonal GBS (75%). Our study also confirms a higher MFS rate for paediatric GBS in East Asia region and our study has the highest MFS rate (25.4%). Our population-based 10-year paediatric GBS study provides updated evidence on estimated incidence, healthcare burden and motor outcome of each subtype of paediatric GBS and confirmed a higher occurrence of paediatric MFS in East Asia.
ISSN:0387-7604
1872-7131
DOI:10.1016/j.braindev.2022.07.003