Occurrence of Guillain-Barré syndrome as an immune mediated complication after thrombolysis with streptokinase for acute anterior wall myocardial infarction: a caution to be vigilant

BMJ Case Rep. 2013 Oct 7:2013:bcr2013200602. doi: 10.1136/bcr-2013-200602.

Abstract

Guillain-Barré syndrome (GBS) constitutes a heterogeneous group of immune-mediated peripheral neuropathic disorders that can be triggered by a variety of antecedent events. Clinical symptoms are thought to result from streptokinase antibody-mediated damage to the local blood-nerve barrier. We report the case of a 50-year-old man with acute anterior wall myocardial infarction who developed GBS as a manifestation of autoimmune hypersensitivity reaction to the drug 17 days after thrombolytic therapy with streptokinase. The patient was treated with a 5-day course of intravenous γ globulin and his symptoms improved and there was no residual deficit. The case forms a reminder of the autoimmune complications of non-fibrin specific agents that can sometimes be catastrophic and require persistent and vigilant in-hospital and immediate postdischarge follow-up and immediate management.

Publication types

  • Case Reports

MeSH terms

  • Anterior Wall Myocardial Infarction / drug therapy*
  • Fibrinolytic Agents / adverse effects*
  • Guillain-Barre Syndrome / chemically induced*
  • Guillain-Barre Syndrome / immunology
  • Humans
  • Immunization, Passive
  • Immunologic Factors / therapeutic use*
  • Male
  • Middle Aged
  • Streptokinase / adverse effects*
  • gamma-Globulins / therapeutic use

Substances

  • Fibrinolytic Agents
  • Immunologic Factors
  • gamma-Globulins
  • Streptokinase