Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil

Detalhes bibliográficos
Autor(a) principal: Dourado Junior, Mário Emílio Teixeira
Data de Publicação: 2021
Outros Autores: Sousa, Bruno Fernandes de, Costa, Nathaly M. Coelho da, Jeronimo, Selma Maria Bezerra
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFRN
Texto Completo: https://repositorio.ufrn.br/handle/123456789/53506
https://doi.org/10.1590/0004-282X-ANP-2020-0464
Resumo: Background: Guillain-Barré syndrome (GBS) is currently the most common cause of acute flaccid paralysis worldwide. Risk factors for GBS include previous viral or bacterial infections or vaccination. Recently, an outbreak of Zika virus led to an outbreak of GBS in Latin America, mostly in Brazil, concomitant to continuous circulation of dengue virus serotypes. However, there is no study about cytomegalovirus (CMV) infection as a risk for GBS in Brazil. Objectives: In this study, we report a series of cases of GBS with the aim of determining the prevalence of CMV and the characteristics associated with the infection. Methods: A cohort of 111 GBS cases diagnosed between 2011 and 2017 in Natal, northeastern Brazil, was studied. Presence of CMV IgM antibodies was determined by means of electrochemiluminescence. The analysis was performed considering CMV infection status and the clinical outcome. Results: We found seroprevalence of 15.3% (n = 17) for CMV. CMV patients were younger (26 vs. 40; p = 0.016), with no apparent gastrointestinal (p = 0.762) or upper respiratory infections (p = 0.779) or sensory loss (p = 0.03). They presented more often with a classic GBS sensorimotor variant (p = 0.02) and with a demyelinating pattern in electrophysiological studies (p < 0.001). Conclusion: In Brazil, the clinical-epidemiological profile of GBS associated with CMV infection is similar to that described in other countries. Better understanding of the relationship between infectious processes and GBS is a key component of the research agenda and assistance strategy for global health initiatives relating to peripheral neuropathic conditions.
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spelling Dourado Junior, Mário Emílio TeixeiraSousa, Bruno Fernandes deCosta, Nathaly M. Coelho daJeronimo, Selma Maria Bezerrahttps://orcid.org/0000-0002-9462-22942023-07-17T17:12:22Z2023-07-17T17:12:22Z2021DOURADO JUNIOR, Mario Emilio Teixeira; SOUSA, Bruno Fernandes de; COSTA, Nathaly M. Coelho da; JERONIMO, Selma Maria Bezerra. Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in brazil. Arquivos de Neuro-Psiquiatria, [S.L.], v. 79, n. 7, p. 607-611, jul. 2021. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/0004-282x-anp-2020-0464. Disponível em: https://www.scielo.br/j/anp/a/W7FvKWchXgVCxkvysVVZ4Gb/?lang=en#. Acesso em: 17 jul. 2023.https://repositorio.ufrn.br/handle/123456789/53506https://doi.org/10.1590/0004-282X-ANP-2020-0464Background: Guillain-Barré syndrome (GBS) is currently the most common cause of acute flaccid paralysis worldwide. Risk factors for GBS include previous viral or bacterial infections or vaccination. Recently, an outbreak of Zika virus led to an outbreak of GBS in Latin America, mostly in Brazil, concomitant to continuous circulation of dengue virus serotypes. However, there is no study about cytomegalovirus (CMV) infection as a risk for GBS in Brazil. Objectives: In this study, we report a series of cases of GBS with the aim of determining the prevalence of CMV and the characteristics associated with the infection. Methods: A cohort of 111 GBS cases diagnosed between 2011 and 2017 in Natal, northeastern Brazil, was studied. Presence of CMV IgM antibodies was determined by means of electrochemiluminescence. The analysis was performed considering CMV infection status and the clinical outcome. Results: We found seroprevalence of 15.3% (n = 17) for CMV. CMV patients were younger (26 vs. 40; p = 0.016), with no apparent gastrointestinal (p = 0.762) or upper respiratory infections (p = 0.779) or sensory loss (p = 0.03). They presented more often with a classic GBS sensorimotor variant (p = 0.02) and with a demyelinating pattern in electrophysiological studies (p < 0.001). Conclusion: In Brazil, the clinical-epidemiological profile of GBS associated with CMV infection is similar to that described in other countries. Better understanding of the relationship between infectious processes and GBS is a key component of the research agenda and assistance strategy for global health initiatives relating to peripheral neuropathic conditions.Introdução: Aproximadamente 2/3 dos pacientes com a Síndrome de Guillain-Barré (SGB) apresentam alguma doença infecciosa precedente. Recentemente, uma epidemia de infecção por o vírus Zika resultou em surto de SGB na América Latina, principalmente no Brasil, concomitante à circulação contínua de sorotipos do vírus da Dengue. No entanto, não há estudo sobre a infecção por citomegalovírus (CMV) como fator de risco para SGB no Brasil. Objetivos: Neste estudo, relatamos uma série de casos de SGB com o intuito de determinar a prevalência de CMV e as características associadas à infecção. Métodos: Foi estudada uma coorte de 111 casos de SGB diagnosticados entre 2011 e 2017 na cidade de Natal, capital do estudo do Rio Grande do Norte, nordeste do Brasil. A presença de anticorpos IgM CMV foi determinada por eletroquimiluminescência. A análise foi realizada considerando o status de infecção por CMV e os achados clínicos. Resultados: Foi observada uma soroprevalência de 15,3% (n = 17) para o CMV. Os casos de CMV eram mais jovens (26 vs. 40, p = 0,016), sem história de infecção gastrointestinal (p = 0,762) ou respiratória superior (0,779) ou perda sensorial (p = 0,03). Apresentaram-se mais frequentemente como uma variante sensitiva-motora clássica da SGB (p = 0,02) e subtipo desmielinizante nos estudos eletrofisiológicos (p <0,001). Conclusão: No Brasil, o perfil clínico-epidemiológico do SGB associado à infecção por CMV é semelhante ao descrito em outros países. O melhor entendimento das relações entre processos infecciosos e SGB é um componente-chave de uma agenda de pesquisa e estratégia de assistência para iniciativas globais de saúde em neuropatia periféricaArquivos de Neuro-PsiquiatriaAttribution 3.0 Brazilhttp://creativecommons.org/licenses/by/3.0/br/info:eu-repo/semantics/openAccesscytomegalovirus infectionsguillain-barré syndromeepidemiologybrazilCytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in BrazilInfecção por citomegalovirus na Síndrome de Guillain-Barré: um estudo retrospectivo no Brasilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleengreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8914https://repositorio.ufrn.br/bitstream/123456789/53506/2/license_rdf4d2950bda3d176f570a9f8b328dfbbefMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81484https://repositorio.ufrn.br/bitstream/123456789/53506/3/license.txte9597aa2854d128fd968be5edc8a28d9MD53ORIGINALCytomegalovirusInfection_DouradoJr_2021.pdfCytomegalovirusInfection_DouradoJr_2021.pdfapplication/pdf113184https://repositorio.ufrn.br/bitstream/123456789/53506/4/CytomegalovirusInfection_DouradoJr_2021.pdfb2f3781eb641f14eaf527d461bda3336MD54123456789/535062023-07-17 14:13:12.488oai:https://repositorio.ufrn.br:123456789/53506Tk9OLUVYQ0xVU0lWRSBESVNUUklCVVRJT04gTElDRU5TRQoKCkJ5IHNpZ25pbmcgYW5kIGRlbGl2ZXJpbmcgdGhpcyBsaWNlbnNlLCBNci4gKGF1dGhvciBvciBjb3B5cmlnaHQgaG9sZGVyKToKCgphKSBHcmFudHMgdGhlIFVuaXZlcnNpZGFkZSBGZWRlcmFsIFJpbyBHcmFuZGUgZG8gTm9ydGUgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgb2YKcmVwcm9kdWNlLCBjb252ZXJ0IChhcyBkZWZpbmVkIGJlbG93KSwgY29tbXVuaWNhdGUgYW5kIC8gb3IKZGlzdHJpYnV0ZSB0aGUgZGVsaXZlcmVkIGRvY3VtZW50IChpbmNsdWRpbmcgYWJzdHJhY3QgLyBhYnN0cmFjdCkgaW4KZGlnaXRhbCBvciBwcmludGVkIGZvcm1hdCBhbmQgaW4gYW55IG1lZGl1bS4KCmIpIERlY2xhcmVzIHRoYXQgdGhlIGRvY3VtZW50IHN1Ym1pdHRlZCBpcyBpdHMgb3JpZ2luYWwgd29yaywgYW5kIHRoYXQKeW91IGhhdmUgdGhlIHJpZ2h0IHRvIGdyYW50IHRoZSByaWdodHMgY29udGFpbmVkIGluIHRoaXMgbGljZW5zZS4gRGVjbGFyZXMKdGhhdCB0aGUgZGVsaXZlcnkgb2YgdGhlIGRvY3VtZW50IGRvZXMgbm90IGluZnJpbmdlLCBhcyBmYXIgYXMgaXQgaXMKdGhlIHJpZ2h0cyBvZiBhbnkgb3RoZXIgcGVyc29uIG9yIGVudGl0eS4KCmMpIElmIHRoZSBkb2N1bWVudCBkZWxpdmVyZWQgY29udGFpbnMgbWF0ZXJpYWwgd2hpY2ggZG9lcyBub3QKcmlnaHRzLCBkZWNsYXJlcyB0aGF0IGl0IGhhcyBvYnRhaW5lZCBhdXRob3JpemF0aW9uIGZyb20gdGhlIGhvbGRlciBvZiB0aGUKY29weXJpZ2h0IHRvIGdyYW50IHRoZSBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkbyBSaW8gR3JhbmRlIGRvIE5vcnRlIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdCB0aGlzIG1hdGVyaWFsIHdob3NlIHJpZ2h0cyBhcmUgb2YKdGhpcmQgcGFydGllcyBpcyBjbGVhcmx5IGlkZW50aWZpZWQgYW5kIHJlY29nbml6ZWQgaW4gdGhlIHRleHQgb3IKY29udGVudCBvZiB0aGUgZG9jdW1lbnQgZGVsaXZlcmVkLgoKSWYgdGhlIGRvY3VtZW50IHN1Ym1pdHRlZCBpcyBiYXNlZCBvbiBmdW5kZWQgb3Igc3VwcG9ydGVkIHdvcmsKYnkgYW5vdGhlciBpbnN0aXR1dGlvbiBvdGhlciB0aGFuIHRoZSBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkbyBSaW8gR3JhbmRlIGRvIE5vcnRlLCBkZWNsYXJlcyB0aGF0IGl0IGhhcyBmdWxmaWxsZWQgYW55IG9ibGlnYXRpb25zIHJlcXVpcmVkIGJ5IHRoZSByZXNwZWN0aXZlIGFncmVlbWVudCBvciBhZ3JlZW1lbnQuCgpUaGUgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZG8gUmlvIEdyYW5kZSBkbyBOb3J0ZSB3aWxsIGNsZWFybHkgaWRlbnRpZnkgaXRzIG5hbWUgKHMpIGFzIHRoZSBhdXRob3IgKHMpIG9yIGhvbGRlciAocykgb2YgdGhlIGRvY3VtZW50J3MgcmlnaHRzCmRlbGl2ZXJlZCwgYW5kIHdpbGwgbm90IG1ha2UgYW55IGNoYW5nZXMsIG90aGVyIHRoYW4gdGhvc2UgcGVybWl0dGVkIGJ5CnRoaXMgbGljZW5zZQo=Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2023-07-17T17:13:12Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.pt_BR.fl_str_mv Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
dc.title.alternative.pt_BR.fl_str_mv Infecção por citomegalovirus na Síndrome de Guillain-Barré: um estudo retrospectivo no Brasil
title Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
spellingShingle Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
Dourado Junior, Mário Emílio Teixeira
cytomegalovirus infections
guillain-barré syndrome
epidemiology
brazil
title_short Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
title_full Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
title_fullStr Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
title_full_unstemmed Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
title_sort Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in Brazil
author Dourado Junior, Mário Emílio Teixeira
author_facet Dourado Junior, Mário Emílio Teixeira
Sousa, Bruno Fernandes de
Costa, Nathaly M. Coelho da
Jeronimo, Selma Maria Bezerra
author_role author
author2 Sousa, Bruno Fernandes de
Costa, Nathaly M. Coelho da
Jeronimo, Selma Maria Bezerra
author2_role author
author
author
dc.contributor.authorID.pt_BR.fl_str_mv https://orcid.org/0000-0002-9462-2294
dc.contributor.author.fl_str_mv Dourado Junior, Mário Emílio Teixeira
Sousa, Bruno Fernandes de
Costa, Nathaly M. Coelho da
Jeronimo, Selma Maria Bezerra
dc.subject.por.fl_str_mv cytomegalovirus infections
guillain-barré syndrome
epidemiology
brazil
topic cytomegalovirus infections
guillain-barré syndrome
epidemiology
brazil
description Background: Guillain-Barré syndrome (GBS) is currently the most common cause of acute flaccid paralysis worldwide. Risk factors for GBS include previous viral or bacterial infections or vaccination. Recently, an outbreak of Zika virus led to an outbreak of GBS in Latin America, mostly in Brazil, concomitant to continuous circulation of dengue virus serotypes. However, there is no study about cytomegalovirus (CMV) infection as a risk for GBS in Brazil. Objectives: In this study, we report a series of cases of GBS with the aim of determining the prevalence of CMV and the characteristics associated with the infection. Methods: A cohort of 111 GBS cases diagnosed between 2011 and 2017 in Natal, northeastern Brazil, was studied. Presence of CMV IgM antibodies was determined by means of electrochemiluminescence. The analysis was performed considering CMV infection status and the clinical outcome. Results: We found seroprevalence of 15.3% (n = 17) for CMV. CMV patients were younger (26 vs. 40; p = 0.016), with no apparent gastrointestinal (p = 0.762) or upper respiratory infections (p = 0.779) or sensory loss (p = 0.03). They presented more often with a classic GBS sensorimotor variant (p = 0.02) and with a demyelinating pattern in electrophysiological studies (p < 0.001). Conclusion: In Brazil, the clinical-epidemiological profile of GBS associated with CMV infection is similar to that described in other countries. Better understanding of the relationship between infectious processes and GBS is a key component of the research agenda and assistance strategy for global health initiatives relating to peripheral neuropathic conditions.
publishDate 2021
dc.date.issued.fl_str_mv 2021
dc.date.accessioned.fl_str_mv 2023-07-17T17:12:22Z
dc.date.available.fl_str_mv 2023-07-17T17:12:22Z
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dc.identifier.citation.fl_str_mv DOURADO JUNIOR, Mario Emilio Teixeira; SOUSA, Bruno Fernandes de; COSTA, Nathaly M. Coelho da; JERONIMO, Selma Maria Bezerra. Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in brazil. Arquivos de Neuro-Psiquiatria, [S.L.], v. 79, n. 7, p. 607-611, jul. 2021. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/0004-282x-anp-2020-0464. Disponível em: https://www.scielo.br/j/anp/a/W7FvKWchXgVCxkvysVVZ4Gb/?lang=en#. Acesso em: 17 jul. 2023.
dc.identifier.uri.fl_str_mv https://repositorio.ufrn.br/handle/123456789/53506
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1590/0004-282X-ANP-2020-0464
identifier_str_mv DOURADO JUNIOR, Mario Emilio Teixeira; SOUSA, Bruno Fernandes de; COSTA, Nathaly M. Coelho da; JERONIMO, Selma Maria Bezerra. Cytomegalovirus infection in Guillain-Barré syndrome: a retrospective study in brazil. Arquivos de Neuro-Psiquiatria, [S.L.], v. 79, n. 7, p. 607-611, jul. 2021. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/0004-282x-anp-2020-0464. Disponível em: https://www.scielo.br/j/anp/a/W7FvKWchXgVCxkvysVVZ4Gb/?lang=en#. Acesso em: 17 jul. 2023.
url https://repositorio.ufrn.br/handle/123456789/53506
https://doi.org/10.1590/0004-282X-ANP-2020-0464
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