Title : An observational prospective study of Guillain Barre syndrome (GBS) associated with enteric infection at North India, SMS Medical College, Jaipur
Abstract:
Background: Guillain-Barré Syndrome (GBS) is an acute, immune-mediated neuropathy frequently triggered by gastrointestinal or respiratory infections or vaccine induced. Among these, Campylobacter jejuni is the most widely recognized antecedent pathogen. This study aimed to evaluate the association of gastroenteritis with GBS through stool pathogen detection and its correlation with nerve conduction velocity study subtypes and CSF findings in North India, SMS Medical College & Hospitals, Jaipur.
Methods: An Observational Prospective Study was conducted at a tertiary-care center which includes Thirty-four patients with clinically diagnosed GBS. Demographic, clinical, biochemical, CSF, stool BioFire pathogen panel, and nerve conduction study (NCV) data were analyzed. NCV findings were classified into demyelinating, axonal, mixed, or normal. Chi-square and Spearman correlation tests were used to assess statistical associations.
Results: Median patient age was 33 years (range 16–82). Most patients have classical albuminocytologic dissociation on CSF. In this study 79% of patients of GBS had detected positive pathogens in stool Bio fire result with most frequent detected pathogen was diarhogenic E Coli (EAEC, EPEC, ETEC, STEC) (24%) followed by Norovirus (21%), Campylobacter jejuni (14%), Sapovirus (10%), Clostridium difficile toxin A/B (5%) in decreasing order. NCV revealed a predominance of axonal variants (44%), followed by demyelinating (24%) and mixed subtypes (15%). No significant association was found between stool pathogen positivity and NCV subtype (χ² = 0.0, p = 1.0). CSF protein levels showed a weak, non-significant correlation with NCV severity (Spearman ρ = 0.14, p = 0.455).
Conclusion: Gastroenteritis is a frequent antecedent of GBS in India, with Diarrheagenic E. coli strains and Norovirus (21%) Sapo virus (10%) emerged as leading pathogens. However, stool pathogen detection does not predict electrophysiological subtype or severity. Axonal variants predominate in this Indian cohort, consistent with Asian epidemiology.
Keywords: Campylobacter jejuni, CSF protein, Guillain-Barré Syndrome, Gastroenteritis, Norovirus.
