Guillain-Barré syndrome associated with cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation

Transpl Infect Dis. 2005 Jun;7(2):93-6. doi: 10.1111/j.1399-3062.2005.00098.x.

Abstract

The association between cytomegalovirus (CMV) infection and the development of Guillain-Barré syndrome (GBS) in the setting of allogeneic hematopoietic stem cell transplantation (alloSCT) has been reported only occasionally. We describe here a 23-year-old patient diagnosed with acute myelogenous leukemia who underwent a partially HLA-mismatched alloSCT and soon after developed GBS along with a CMV infection. Serum autoantibodies to several ganglioside antigens were concomitantly detected. Despite therapy with ganciclovir and plasma exchanges, the patient's clinical condition rapidly deteriorated, and he died 3 weeks later with persisting CMV antigenemia. Although a coincidental association cannot be excluded, it could be speculated that a pathogenetic link exists between the 2 disorders. In this sense, molecular mimicry between viral antigens and neural host tissues could be postulated as the hypothetical mechanism underlying the triggering of the autoimmune disease in the present case.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cytomegalovirus Infections / complications*
  • Guillain-Barre Syndrome / etiology*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Transplantation, Homologous / adverse effects*