Influenza virus vaccine
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Influenza virus vaccine Guillain-Barre syndrome: case report
A 67-year-old man developed Guillain-Barre syndrome (GBS) following immunisation with influenza virus vaccine. The man, who had a history of hyperlipidaemia, hypertension, gastroesophageal reflux disease and emphysema, presented with tingling sensation in hands and feet and abdominal distention since 1 day prior to presentation. Initial physical examination revealed diminished motor strength in the lower (2/5) and upper extremities (3/5) with areflexia. During hospitalisation, he developed generalised weakness and ataxia. After 36 hours of admission, he experienced respiratory muscle weakness and worsening of negative inspiratory force. Subsequently, he developed hypercapnic respiratory failure necessitating endotracheal intubation. Infectious aetiology was negative. During anamnesis, he reported immunisation with influenza virus vaccine 2 weeks prior to admission [dosage and route not stated]. An electromyography findings were suggestive of acute demyelinating polyneuropathy. Based on clinical presentation and risk factor of vaccination, he was diagnosed with GBS. The man was treated with IV immune globulin (IVIG) for 5 days; however, he still required mechanical ventilation. Subsequently, he underwent tracheostomy and percutaneous endoscopic gastrostomy because of dysphagia. Thereafter, he received one course of plasmapheresis and two additional courses of IV immune globulin resulting in improved motor function and weaning of mechanical ventilation. He was discharged after physical rehabilitation. Rodriguez W, et al. One in a million: Guillain-Barre syndrome. American Journal of Respiratory and Critical Care Medicine 199: (plus poster) abstr. A1775, No. 9, May 803447379 2019. Available from: URL: http://doi.org/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A1775 [abstract]
» Editorial comment: Details of this case report have previously been published [see Reactions 1748 p260; 803384030].
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Reactions 18 Jan 2020 No. 1787
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