Association of CSF Total Protein with Clinical Heterogeneity, Disease Severity and Electrophysiological Pattern in GBS Patients.

Mymensingh medical journal : MMJ Pub Date : 2024-04-01
H Rahaman, H Z Rahman, M M Emran, M A Rahman
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Abstract

Guillain-Barre Syndrome (GBS) is considered as an immune mediated inflammatory disease of peripheral nerves and nerve roots. The significance of CSF total protein (CSF-TP) in subtypes of Guillain-Barre syndrome has not been well established. This observational, cross sectional study's aim was to identify association of CSF total protein with clinical heterogeneity, disease severity and electrophysiological subtypes in GBS patients. This study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from September 2017 to February 2019 on 50 (fifty) admitted GBS patients as per inclusion and exclusion criteria. About 3-5 ml of CSF was taken around 10±2 days from disease onset for detection CSF cell count and protein. Pattern of clinical presentation, disability status by Hughes scale and NCS findings of these patients was documented. Mean CSF-TP were substantially higher for Sensori-motor GBS (195.42 mg/dl) and GBS with cranial involvement (226.12 mg/dl) than that of GBS with motor (134.00 mg/dl) and autonomic involvement (155.21 mg/dl). Mean CSF total protein (CSF-MTP) in severely ill GBS patients (Grade-IV) was 217.04 mg/dl and very severely ill GBS patients (Grade-V) was 138.00mg/dl which was significantly higher than mean CSF total protein in mild GBS patients (CSF-MTP: 99.86mg/dl) and moderately ill GBS patients (CSF-MTP: 172.00 mg/dl). Mean CSF total protein is 245.00mg/dl in AIDP which is also higher than mean CSF total protein of AMAN (153.36 mg/dl) and AMSAN (165.17mg/dl). CSF-TP is thought to be a sensitive test for GBS in the second week after onset, but it may be a reliable predictor of clinical severity. There is a significant association of CSF-TP elevation with demyelinating electrophysiologic pattern.

脑脊液总蛋白与 GBS 患者临床异质性、疾病严重程度和电生理模式的关系
格林-巴利综合征(GBS)被认为是一种由免疫介导的周围神经和神经根炎性疾病。脑脊液总蛋白(CSF-TP)在吉兰-巴利综合征亚型中的意义尚未明确。这项观察性横断面研究旨在确定 CSF 总蛋白与 GBS 患者的临床异质性、疾病严重程度和电生理亚型之间的关系。本研究于 2017 年 9 月至 2019 年 2 月在孟加拉国班加班杜谢赫-穆吉布医科大学(BSMMU)神经病学系进行,根据纳入和排除标准对 50(五十)名入院的 GBS 患者进行了研究。在发病 10±2 天左右抽取约 3-5 毫升 CSF,用于检测 CSF 细胞计数和蛋白质。记录了这些患者的临床表现模式、休斯量表显示的残疾状况以及 NCS 结果。感觉-运动型 GBS(195.42 mg/dl)和颅骨受累型 GBS(226.12 mg/dl)的平均 CSF-TP 明显高于运动型 GBS(134.00 mg/dl)和自主神经受累型 GBS(155.21 mg/dl)。重症 GBS 患者(IV 级)的平均 CSF 总蛋白(CSF-MTP)为 217.04 mg/dl,极重症 GBS 患者(V 级)为 138.00 mg/dl,明显高于轻症 GBS 患者(CSF-MTP:99.86 mg/dl)和中度 GBS 患者(CSF-MTP:172.00 mg/dl)的平均 CSF 总蛋白。AIDP 患者的平均 CSF 总蛋白为 245.00 毫克/分升,也高于 AMAN(153.36 毫克/分升)和 AMSAN(165.17 毫克/分升)患者的平均 CSF 总蛋白。CSF-TP 被认为是对发病后第二周内 GBS 的敏感检测,但它可能是临床严重程度的可靠预测指标。CSF-TP 升高与脱髓鞘电生理模式有明显关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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