Abstract
Anecdotal reports of acute inflammatory demyelinating polyneuropathy (Guillain–Barré syndrome) with cytomegalovirus (CMV) suggested as the etiological agent have been described in transplant recipients with poor prognosis. We describe a 48-year-old man, a cadaveric renal allograft recipient on cyclosporine, mycophenolate mofetil and prednisolone, who developed febrile illness with unexplained anemia followed by progressive weakness of the upper and lower limbs. He was diagnosed as a case of Guillain–Barré syndrome (GBS). His CMV serology was positive by polymerase chain reaction (PCR). We treated him with both gancyclovir and intravenous immunoglobulins within a week of the onset of GBS and observed rapid recovery. Thus, search for CMV is warranted in transplant patients presenting with GBS, as early initiation of treatment with gancyclovir and immunoglobulins can help expedite recovery.
Similar content being viewed by others
References
van der Meche F Schmitz GPI (1992) A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barre syndrome. Dutch Guillain-Barre Study Group. N Engl J Med 326(17):1123–1129
Bulsara KR, Baron PW Tuttle-Newhall JE et al (2001) Guillain-Barre syndrome in organ and bone marrow transplant patients. Transplantation 71(8):1169–1172
Rodriguez V, Kuehnle I Heslop HE et al (2002) Guillain-Barre syndrome after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 29(6):515–751
El-Sabrout RA, Radovancevic B Ankoma-Sey V et al (2001) Guillain-Barre syndrome after solid organ transplantation. Transplantation 71(9):1311–1316
Visser LH, van der Meche FG Meulstee J et al (1996) Cytomegalovirus infection and Guillain-Barre syndrome: the clinical, electrophysiologic, and prognostic features. Dutch Guillain-Barre Study Group Neurology 47(3):668–673
Hernandez-Boluda JC, Lis MJ Goterris R et al (2005) Guillain-Barre syndrome associated with cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 7(2):93–96
Asbury A Cornblath KDR (1990) Assessment of current diagnostic criteria for Guillain-Barre syndrome. Ann Neurol 27Suppl:S21–S24
Ponticelli CM Campise R (2005) Neurological complications in kidney transplant recipients. J Nephrol 18(5):521–528
Hughes R Cornblath ADR (2005) Guillain-Barre syndrome. Lancet 366(9497):1653–1666
Wen PY, Alyea EP Simon D et al (1997) Guillain-Barre syndrome following allogeneic bone marrow transplantation. Neurology 49(6):1711–1714
Perry A, Mehta J Iveson T et al (1994) Guillain-Barre syndrome after bone marrow transplantation. Bone Marrow Transplant 14(1):165–167
Hartung HP, van der Meche FG Pollard JD (1998) Guillain-Barre syndrome, CIDP and other chronic immune-mediated neuropathies. Curr Opin Neurol 11(5):497–513
Yuki N (2001) Infectious origins of, and molecular mimicry in, Guillain-Barre and Fisher syndromes. Lancet Infect Dis 1(1):29–37
Hartung HP, Pollard JD Harvey GK et al (1995) Immunopathogenesis and treatment of the Guillain-Barre syndrome–Part II. Muscle Nerve 18(2):154–164
Susuki K, Odaka M Mori M et al (2004) Acute motor axonal neuropathy after Mycoplasma infection: Evidence of molecular mimicry. Neurology 62(6):949–956
Visser LH, Schmitz PI Meulstee J et al (1999) Prognostic factors of Guillain-Barre syndrome after intravenous immunoglobulin or plasma exchange. Dutch Guillain-Barre Study Group Neurology 53(3):598–604
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Keithi-Reddy, S.R.R., Chakravarthi, R.M., Hussaini, S.M. et al. Cytomegalovirus disease with Guillain–Barré syndrome in a cadaver renal allograft recipient: cause or coincidence. Int Urol Nephrol 39, 967–970 (2007). https://doi.org/10.1007/s11255-007-9197-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-007-9197-7