1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-56 10.15844/pedneurbriefs-7-7-12 Infectious Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Hemophilus Influenzae Vaccine and Guillain-Barre http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 07 1993 01 07 2016 7 7 56 56 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Guillain-Barre syndrome following immunisation with Haemophilus influenzae type b conjugate vaccine

A four-year-old girl with Guillain-Barre syndrome that developed 10 days following H influenzae type b conjugate vaccine immunization is reported from Geneva, Switzerland.

 Guillain-Barre Syndrome Polysaccharide Gamma Globulin Therapy

A four-year-old girl with Guillain-Barre syndrome that developed 10 days following H influenzae type b conjugate vaccine immunization is reported from Geneva, Switzerland. CSF contained 1 mononuclear cell/cmm and 0.89 g/1 protein. Nerve conduction velocities were decreased in upper and lower extremities. Measurements of immunoglobulins against the polysaccharide (PRP) component of the vaccine showed a marked elevation (100 mcg/ml) of the anti-PRP IgM antibody level. Following treatment with two 5-day courses of intravenous immunoglobulins (0.4 g/kg/day) 2 weeks apart, cranial nerve function and muscle strength improved. Apart from absent deep tendon reflexes, the neurological exam was normal at one month follow-up. [1]

COMMENT. A total of five cases of Guillain-Barre syndrome (GBS) following vaccination with the H influenzae type b diphtheria toxoid-conjugate vaccine have been reported. The authors speculate that an excessive anti-PRP IgM antibody response to the vaccine might explain this rare complication.

Treatment of acute GBS is controversial and not without risk, especially in patients with vascular disease. Two adults died from vascular thrombotic complications following gamma globulin therapy for GBS. [2]

 Gervaix A Caflisch M Suter S Haenggeli CA Guillain-Barre syndrome following immunisation with Haemophilus influenzae type b conjugate vaccine Eur J Pediatr 1993 Jul 152 7 613 614 10.1007/BF01954093 8354324 McFarland HR What treatment for the Guillain-Barre syndrome? Arch Neurol 1993 Jul 50 7 687 688 10.1001/archneur.1993.00540070007004 8323468