Correlation of Serum Vitamin B12 and Muscle Enzyme (CK-NAC) Level with Severity of Guillain-Barre Syndrome and Its Prediction in Respiratory Failure.

Abstract

Background: Guillain-Barré syndrome (GBS) is an acute-onset polyneuropathy. Several biomarkers have been identified to monitor prognosis in GBS, including serum folate, serum albumin, blood glucose, serum sodium, and plasma cortisol levels.

Objectives: To study the prevalence of serum vitamin B₁₂ deficiency and increased creatine kinase (CK-NAC) levels in GBS patients and ascertain if the levels of serum CK-NAC and vitamin B₁₂ can serve as prognostic indicators in GBS patients.

Materials and methods: The research recruited 50 patients with GBS from the neurology department of a tertiary care hospital between 2020 and 2021. The study assessed the patients' motor function deficits using the MRC (Medical Research Council) scale as well as the HDS (Hughes Disability Scale). Vitamin B₁₂ and CK-NAC levels were measured, and patients were divided into four groups, one of which had a deficiency in vitamin B₁₂ and a raised CK-NAC level, while another group had normal serum vitamin B₁₂ and CK-NAC levels. Clinical characteristics were compared. Serum vitamin B₁₂ and CK-NAC levels were associated with GBS severity based on HDS and MRC scales, autonomic dysfunction, and respiratory failure.

Results: Serum vitamin B₁₂ deficiency along with elevated CK-NAC levels was discovered in 44 and 14% of GBS patients, respectively. Serum vitamin B₁₂ deficiency correlated significantly with GBS severity, including progression duration, admission and nadir HDS scores, and autonomic dysfunction (p < 0.05). CK-NAC level did not correlate with the severity of GBS (p > 0.05).

Conclusion: Vitamin B₁₂ levels can predict prognosis in GBS patients.