POLYRADICULONEURITIS IN AN ADOLESCENT AFTER ACUTE PNEUMONIA

Abstract

Polyradiculoneuritis or Guillan Barré’s Syndrome is the most common cause of acute and subacute generalized paralysis, which is likely to occur at any age. We present the case of a 17-year-old adolescent who was admitted to our clinic for swallowing and phonation disorders, evolving into acute respiratory insufficiency (which required orotracheal intubation and ventilatory support), hypotonia in the upper and lower limbs, and globally-decreased osteotendinous reflexes, abolished in the upper limbs. The thoraco-abdominal X-ray and the chest CT revealed lower respiratory infection, and the neurological clinical examination and the lumbar puncture with albino-cytological dissociation raised the suspicion of polyradiculoneuritis. Therapy with intravenous immunoglobulin resulted in the improvement of the motor deficiency, but without the possibility to detubate the patient. Following 2 sessions of plasmapheresis with 20% human albumin, significant improvement of the neurological deficiency was seen and spontaneous breathing was resumed, the patient regaining full muscle strength.