Navegando por Autor "Leonhard, Sonja E."
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Artigo Antecedent infections in Guillain-Barré syndrome in endemic areas of arbovirus transmission: a multinational case-control study(Wiley, 2021) Dourado Junior, Mário Emílio Teixeira; Leonhard, Sonja E.; Tan, heng Yin; Leonhard, Sonja E; Tan, Cheng Yin; Eijk, Annemiek A.; Reisin, Ricardo R.; Franken, Suzanne C.; Huizinga, Ruth; Arends, Samuel; Batstra, Manou R.; Jeronimo, Selma M. Bezerra; Drenthen, Judith; https://orcid.org/0000-0002-9462-2294Half of the world's population is at risk of arthropod-borne virus (arbovirus) infec-tions. Several arbovirus infections have been associated with Guillain-Barré syn-drome (GBS). We investigated whether arboviruses are driving GBS beyond epidemicphases of transmission and studied the antibody response to glycolipids. The proto-col of the International Guillain-Barré syndrome Outcome Study (IGOS), an observa-tional prospective cohort study, was adapted to a case-control design. Serumsamples were tested for a recent infection with Zika virus (ZIKV), dengue virus(DENV), chikungunya (CHIKV) virus, hepatitis E virus, Epstein-Barr virus (EBV), cyto-megalovirus (CMV),Campylobacter jejuni, andMycoplasma pneumoniae, and for anti-bodies to glycolipids. Forty-nine patients were included from Brazil (63%), Argentina(14%), and Malaysia (22%). Evidence of a recent infection was found in 27/49 (55%)patients:C jejuni(n=15, 31%),M pneumoniae(n=5, 10%), CHIKV (n=2, 4%), EBV(n=1, 2%),C jejuniandM pneumoniae(n=2, 4%), CMV and DENV (n=1, 2%), andC jejuniand DENV (n=1, 2%). In 22 patients, 35 paired controls were collected.Odds ratio for recent infections did not significantly differ between cases and con-trols. No typical anti-ganglioside antibody binding was associated with recent arbovi-rus infection. We conclude that arbovirus infections occur in GBS patients outside ofepidemic viral transmission, although not significantly more than in controls. Broadinfection and anti-ganglioside antibody serology are important to establish the mostlikely pathogenic trigger in GBS patients. Larger studies are necessary to determinethe association between arboviruses and GBS.Artigo Diagnosis and management of Guillain–Barré syndrome in ten steps(Springer, 2019) Dourado Junior, Mário Emílio Teixeira; Leonhard, Sonja E.; Mandarakas, Melissa R.; et al.; https://orcid.org/0000-0002-9462-2294Guillain–Barré syndrome (GBS) is a rare, but potentially fatal, immune-mediated disease of the peripheral nerves and nerve roots that is usually triggered by infections. The incidence of GBS can therefore increase during outbreaks of infectious diseases, as was seen during the Zika virus epidemics in 2013 in French Polynesia and 2015 in Latin America. Diagnosis and management of GBS can be complicated as its clinical presentation and disease course are heterogeneous, and no international clinical guidelines are currently available. To support clinicians, especially in the context of an outbreak, we have developed a globally applicable guideline for the diagnosis and management of GBS. The guideline is based on current literature and expert consensus, and has a ten-step structure to facilitate its use in clinical practice. We first provide an introduction to the diagnostic criteria, clinical variants and differential diagnoses of GBS. The ten steps then cover early recognition and diagnosis of GBS, admission to the intensive care unit, treatment indication and selection, monitoring and treatment of disease progression, prediction of clinical course and outcome, and management of complications and sequelae.