Streptokinase
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Guillain-Barre´ syndrome in an elderly patient: case report A 70-year-old obese man developed Guillain-Barr´e syndrome during treatment with streptokinase for acute myocardial infarction (MI). The man received 1 500 000 units of streptokinase [route and frequency not stated] after presenting to the ED with dyspnoea and chest pain radiating from his left shoulder. Five days after admission, he was discharged in good condition. However, 7 days after receiving streptokinase he presented with a 1-day history of a pins and needles sensation in his hands and feet as well as general lethargy. He subsequently developed distal sensory impairment and progressive muscle weakness in his lower extremities. Examination revealed decreased muscle power and areflexia. Guillain-Barr´e syndrome was suspected, and he was subsequently hospitalised in ICU. Cerebrospinal fluid analysis showed a CSF–to–serum glucose ratio of 0.65, cell count of 4 cells/mm3 and protein level of 90 mg/dL. He developed respiratory failure and he was intubated, requiring ventilatory support. Nerve conduction findings were indicative of acute generalised peripheral sensory motor polyneuropathy. The man was treated with immunoglobulins and plasmapheresis. His condition slowly improved and he was discharged 1 month later. At this time, his muscle power had returned to 3 of 5 in all extremities. Eshraghian A, et al. Guillain-barre syndrome after streptokinase therapy for acute myocardial infarction. Internal Medicine 49: 2445-2446, No. 22, 2010. Available 803047185 from: URL: http://dx.doi.org/10.2169/internalmedicine.49.3900 - Iran
0114-9954/10/1334-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Jan 2011 No. 1334
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