HIV感染合并格林巴利综合征一例并文献复习-东南大学学报医学版

HIV感染合并格林巴利综合征一例并文献复习

单位：南京市第二医院感染性疾病科, 江苏南京 210000

分类号：R512.91;R744.5

出版年·卷·期（页码）：2022·41·第五期（713-716）

摘要：

目的：探讨人类免疫缺陷病毒（HIV）感染合并格林巴利综合征（GBS）的诊治经验。方法：回顾性分析南京市第二医院感染性疾病科2021年收治的1例HIV感染合并GBS患者的临床资料，并复习相关文献资料。结果：患者以GBS起病，查出HIV抗体阳性，病情进展迅速，危及生命，经我院多科室积极参与诊治，患者病情逐渐改善，顺利出院。结论：HIV感染可以诱导GBS发生，对于诊断为GBS的患者需注意筛查HIV抗体；反之，对于HIV感染者出现疼痛、对称性异常感觉和（或）肌肉无力等神经系统症状时需警惕GBS发生。HIV相关的GBS诊断与治疗可参考HIV阴性者，为保证患者得到及时有效的治疗，须注意多学科参与。

Objective: To summarize the diagnosis and treatment experience of human immunodeficiency virus(HIV) infection complicated with Guillain-Barré syndrome(GBS). Methods: The clinical data of a case of patient with HIV infection complicated with GBS in Department of Infectious Diseases,The Second Hospital of Nanjing in 2021 were retrospectively analyzed, and the relevant literatures were reviewed. Results: The patient developed the disease with GBS and was found to be HIV antibody positive. The disease progressed rapidly and was life-threatening. With the active participation of multiple departments in our hospital, the patient's condition gradually improved and finally he was discharged. Conclusion: HIV infection can induce GBS, so for patients diagnosed with GBS, attention should be paid to screening HIV antibodies. On the contrary, it is necessary to be alert to the occurrence of GBS in HIV-infected patients with neurological symptoms such as pain, abnormal sensation of symmetry or muscle weakness. The diagnosis and treatment of HIV-related GBS can refer to HIV-negative patients. In order to ensure timely and effective treatment, multiple departments need to actively participate.

参考文献：

[1] MATHUKUMALLI N L, ALI N, KANIKANNAN M A, et al.Worsening Guillain-Barré syndrome:harbingerofIRIS in HIV?[J].Bmj Case Rep, 2017, 2017:bcr-2017-2211874.
[2] GIRGIN N K, İŞÇIMEN R, YILMAZ E, et al.Guillain-Barré syndrome and human immunodeficiency virus[J].Turk J Anaesthesiol Reanim, 2014, 42(2):100-102.
[3] LOPES M, MARQUES P, SILVA B, et al.Guillain-Barré syndrome as the first presentation of human immunodeficiency virus infection[J].BMC Neurol, 2021, 21(1):321.
[4] RABADÁN PEJENAUT E, MARCOS M A, Mallolas J, et al.Guillain-Barré-likesyndrome as a rare presentation of severe primary HIV-infection[J].Enferm Infecc Microbiol Clin(Engl Ed), 2021, 39(10):533-534.
[5] NYATI K K, PRASAD K N, RIZWAN A, et al.TH1 and TH2 response to Campylobacter jejuni antigen in Guillain-Barre syndrome[J].Arch Neurol, 2011, 68(4):445-452.
[6] BRANNAGAN T H 3rd, ZHOU Y.HIV-associated Guillain-Barré syndrome[J].J Neurol Sci, 2003, 208(1-2):39-42.
[7] 周如梦, 邵蓓, 罗璨, 等.中国南方吉兰-巴雷综合征的流行病学和临床特点城乡差异分析[J].中华医学杂志, 2019, 99(43):3432-3436.
[8] 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等.中国吉兰-巴雷综合征诊治指南2019[J].中华神经科杂志, 2019, 52(11):877-882.
[9] BUCHER PRAZ C, DESSIMOZ C, BALLY F, et al.Guillain-Barré syndrome associated with primary parvovirus B19 infection in an HIV-1-infected patient[J].Case Reports in Medicine, 2012, 2012:140780.
[10] 吴小刚, 史灵恩, 陈禹衡, 等.江苏省老年男男性行为人群艾滋病病毒感染状况及危险因素分析[J].东南大学学报(医学版), 2019, 38(6):1055-1059.
[11] 苗冉, 李务荣, 梁洪远, 等.HIV感染合并吉兰-巴雷综合征8例临床分析[J].中风与神经疾病杂志, 2021, 38(9):819-824.
[12] CALZA L, MANFREDI R, MARINACCI G, et al.Role of gancyclovir and HAART administration in the treatment of a rarecomplication of HIV disease:cytomegalovirus-associated Guillain-Barré syndrome[J].J Chemother, 2001, 13(5):575-577.
[13] 马凤杰, 戴丽.与人类免疫缺陷病毒感染有关的GBS[J].国外医学(神经病学神经外科学分册), 1992(5):270-271.
[14] ROSCA E C, ROSCA O, SIMU M.Intravenous immunoglobulin treatment in a HIV-1positive patient with Guillain-Barré syndrome[J].IntImmunopharmacol, 2015, 29(2):964-965.
[15] 何坤, 陈耀凯, 刘敏, 等.艾滋病合并格林-巴利综合征1例[J].中国感染与化疗杂志, 2019, 19(6):677-679.
[16] 康健捷, 杨红军, 邓兵梅, 等.带状疱疹合并吉兰-巴雷综合征1例报道[J].神经损伤与功能重建, 2018, 13(10):539-540.
[17] PONTALI E, FEASI M, CRISALLI M P, et al.Guillain-Barré syndrome with fatal outcome during HIV-1-seroconversion:a case report[J].Case Rep Infect Dis, 2011, 2011:972096.
[18] CASTRO G, BASTOS P G, MARTINEZ R, et al.Episodes of Guillain-Barré syndrome associated with the acute phase of HIV-1 infection andwith recurrence of viremia[J].Arq Neuropsiquiatr, 2006, 64(3A):606-608.
[19] HAHN K, HUSSTEDT I W.HIV-assoziierte neuropathien HIV-associated neuropathies[J].Nervenarzt, 2010, 81(4):409-417.
[20] 罗涵予, 蒋莉.吉兰-巴雷综合征免疫治疗及预后评估研究进展[J].中华实用儿科临床杂志, 2019, 34(24):1907-1910.
[21] 孟香沂.吉兰-巴雷综合征谱系疾病诊疗进展[J].国际儿科学杂志, 2016, 43(11):847-853.
[22] 胡静, 丛树艳.HIV阳性的颅神经损伤的吉兰-巴雷综合征1例报道及文献复习[J].卒中与神经疾病, 2019, 26(4):472, 475.
[23] RALAPANAWA U, KUMARIHAMY P, JAYALATH T, et al.Guillain-Barré syndromewith associated unilateral ptosis without ophthalmoplegia-a rare presentation:a case report and review of the literature[J].J Med Case Rep, 2019, 13(1):221.

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