Population Incidence of Guillain-Barré Syndrome: A Systematic Review and Meta-Analysis

Division of High-Consequence Pathogens and Pathology and Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Neuroepidemiology (Impact Factor: 2.48). 03/2011; 36(2):123-33. DOI: 10.1159/000324710
Source: PubMed

ABSTRACT Population incidence of Guillain-Barré syndrome (GBS) is required to assess changes in GBS epidemiology, but published estimates of GBS incidence vary greatly depending on case ascertainment, definitions, and sample size. We performed a meta-analysis of articles on GBS incidence by searching Medline (1966-2009), Embase (1988-2009), Cinahl (1981-2009) and CABI (1973-2009) as well as article bibliographies. We included studies from North America and Europe with at least 20 cases, and used population-based data, subject matter experts to confirm GBS diagnosis, and an accepted GBS case definition. With these data, we fitted a random-effects negative binomial regression model to estimate age-specific GBS incidence. Of 1,683 nonduplicate citations, 16 met the inclusion criteria, which produced 1,643 cases and 152.7 million person-years of follow-up. GBS incidence increased by 20% for every 10-year increase in age; the risk of GBS was higher for males than females. The regression equation for calculating the average GBS rate per 100,000 person-years as a function of age in years was exp[-12.0771 + 0.01813(age in years)] × 100,000. Our findings provide a robust estimate of background GBS incidence in Western countries. Our regression model may be used in comparable populations to estimate the background age-specific rate of GBS incidence for future studies.

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    • "100 , 000 ( Hughes et al . , 1999 ; Yu et al . , 2006 ) is also a very rare disease ( Sejvar et al . , 2011 ) . Both GBS and ACP are characterized by a bilateral symmetrical ascending weakness of the limbs which can culminate in a generalized paralysis and require the patient to be ventilated ( Winer , 2001 ; Cuddon , 2002 ; Rutter et al . , 2011 ) . Additionally , an involvement of CNs VII , X , or XII might be observed ( Cummings and Haas ,"
    Dataset: jns512011
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    • "We describe two cases of GBS attributed to tacrolimus use after lung transplantation. GBS is an uncommon disease with a worldwide incidence of 1 to 2 cases per 100,000/year [4], whereas the incidence of GBS occurring after solid or bone marrow transplantation is not known. Studies describing complications in bone marrow transplant recipients suggest an incidence of GBS of 0.3–0.7% "
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    ABSTRACT: Guillain-Barré syndrome (GBS) has been described after solid organ and bone marrow transplantation mostly due to viral infections and possibly calcineurin inhibitors. Incidence after bone marrow transplant is 0.3-0.7%, though incidence in other transplants is not well known. We present the first description of tacrolimus associated GBS in lung transplant recipients in the English language literature. The pathophysiology of tacrolimus-induced polyneuropathy is not known, but some have hypothesized that tacrolimus induces an inflammatory phenomenon by differential effects on T cell subsets. Diagnosis of association may be challenging and requires high index of suspicion. The optimal treatment of GBS-associated with tacrolimus after lung transplantation is unknown, although drug discontinuation may result in improvement in some patients, while some reports suggest that the use of IVIG and/or plasmapheresis may be helpful and safe in organ transplant recipients with severe symptoms.
    08/2014; 2014:685010. DOI:10.1155/2014/685010
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    • "Although the age and gender distributions of the included studies in this review suggest that patients samples were representative for GBS (Sejvar et al., 2011), none of the included articles studied HRQL in children with GBS and all but three (Kogos et al., 2005; Demir and Koseoglu, 2008; Khan et al., 2011) studies were performed in European countries, generally covering similar ethnic groups. As a result, the generalizability of findings from these studies to children with GBS and GBS patients in other continents may be problematic. "
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    ABSTRACT: Guillain-Barré syndrome (GBS) encompasses a broad spectrum of health-related quality of life (HRQL) determinants, including mobility, fatigue, pain and depression. We systematically reviewed the literature on functional outcome domains in which GBS patients experience limitations in the short- and long-term, and evaluated determinants of HRQL in GBS patients. Medline and EMBASE were systematically searched by two independent reviewers for articles covering HRQL data of GBS patients. Of 730 abstracts screened, seventeen articles covering data of fourteen studies matched the selection criteria. The included articles showed that many GBS patients experienced physical limitations, even years after the acute phase of the disease, while results were inconsistent for perceived levels of pain, fatigue and general mental well-being. Only three papers covered HRQL assessments at more than one time point, generally showing large improvements in HRQL in the first year after GBS onset, but not thereafter. We appraised the methodological quality of included studies using a thirteen-item checklist; none of the articles fulfilled all items and only seven articles presented data on correlations between HRQL and determinants. In conclusion, the majority of studies on HRQL in GBS patients are cross-sectional and of low methodological quality. This paper provides guidance for much needed high-quality studies on patterns of patient-perceived recovery after GBS onset.
    Journal of the Peripheral Nervous System 01/2014; DOI:10.1111/jns5.12051 · 2.50 Impact Factor
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