Cross-Reactivity of Guillain-Barre Syndrome and Thrombotic Thrombocytopenic Purpura with Complications Respiratory Failure: Case Report

  • Alia Rahmi Harlasgunawan Faculty of Nursing, Universitas Padjadjaran
  • Daud Palo Faculty of Nursing, Universitas Padjadjaran
  • Dirman Abdullah Faculty of Nursing, Universitas Padjadjaran
  • Ayu Prawesti Priambodo Faculty of Nursing, Universitas Padjadjaran
  • Ristina Mirwanti Faculty of Nursing, Universitas Padjadjaran
Keywords: guillain-barre syndrome, respiratory failure, thrombotic thrombocytopenic purpura

Abstract

Guillain-Barre Syndrome (GBS) and Thrombotic Thrombocytopenic Purpura (TTP) are two medical conditions that are rare but can cause serious complications if they appear simultaneously. Both conditions involve autoimmune mechanisms and can result in organ failure, including respiratory failure. Although there are several case reports of each condition, research exploring the interaction between GBS and TTP in the context of respiratory failure is limited. Purpose: The aim of this study is to describe a case of cross-reactivity of Guillian-Barre Syndrome and Thrombotic Thrombocytopenic Purpura with complications respiratory failure. Methods: This research uses a case study design involving an adult patient who was treated at a hospital in Bandung. Data was collected through a comprehensive nursing assessment. Patients provided informed consent before data were collected. Data analysis was carried out descriptively to describe clinical findings and patient management results. Results: The patient is a young woman 27 year old admitted to hospital with a diagnosis of GBS. Eleven days before entering the hospital the patient experience dascending paralysis, fever, nausea and vomiting.TTP cross-reactivity and peripheral nervous system inflammation in GBS.Complications of respiratory failure requiring invasive mechanical ventilation (IMV) in the ICU. Laboratory and radiological examinations supported the diagnosis, and medical intervention was performed according to protocol for both conditions. This shows the importance of close monitoring and prompt treatment to prevent further complications. These findings emphasize the need for a multidisciplinary approach in managing patients with complex medical conditions. Conclusion: An in-depth understanding of the interaction between GBS and TTP is essential for effective clinical management, especially in preventing and managing complications of respiratory failure.

References

Albiol, N., Awol, R., & Martino, R. (2020). Autoimmune thrombotic thrombocytopenic purpura (TTP) associated with COVID-19. Ann Hematol, 99. https://doi.org/10.1007/s00277-020-04097-0

Dalakas, M. C. (2020). Guillain-Barre’ syndrome: the first documented CoVID-19-triggered autoimmune neurologic disease. Neurol Neuroimmunol Neuroinflamm, 7. https://doi.org/10.1212/NXI.0000000000000781

Galassi, G., & Marchioni, A. (2020). Facing acute neuromuscular diseases during COVID-19 pandemic: focus on Guillain–Barré syndrome. Acta Neurologica Belgica, 120(5), 1067–1075. https://doi.org/10.1007/s13760-020-01421-3

Gangula, R. S., Stanley, W., Vandanapu, A., & Prabhu, M. M. (2017). Guillain-Barré syndrome with falciparum malaria and scrub typhus mixed infection-an unusual combination. J Clin Diagn Res, 11.

George, J. N., & Nester, C. M. (2014). Syndromes of Thrombotic Microangiopathy. New England Journal of Medicine, 371(7), 654–666. https://doi.org/10.1056/nejmra1312353

Hagen, K. M., & Ousman, S. S. (2021). The neuroimmunology of Guillain-Barré syndrome and the potential role of an aging immune system. Front Aging Neurosci, 12. https://doi.org/10.3389/fnagi.2020.613628

Hindilerden, F., Yonal-Hindilerden, I., Akar, E., & Kart-Yasar, K. (2020). Covid-19 associated autoimmune thrombotic thrombocytopenic purpura: report of a case. Thromb Res, 195. https://doi.org/10.1016/j.thromres.2020.07.005

Hussain, T., Kumar, J., Singh, S. J., Kumar, A., & Qayum, I. (2022). Concurrent thrombotic thrombocytopenic purpura and Guillian Barre Syndrome post infectious diarrhea. Annals of Medicine and Surgery, 80(July), 104301. https://doi.org/10.1016/j.amsu.2022.104301

Jodjana, E., & Adja, Y. M. I. W. O. (2022). Sindrom Guillain-Barre dengan Komplikasi ( Gagal Nafas, Henti Jantung dan Sepsis). Aksona, 1(2), 81–91. https://doi.org/10.20473/aksona.v1i2.147

Leonhard, S. E., Mandarakas, M. R., & Gondim, F. A. A. (2019). Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol, 15. https://doi.org/10.1038/s41582-019-0250-9

Longhini, F., Pisani, L., & Lungu, R. (2019). High-flow oxygen therapy after noninvasive ventilation interruption in patients recovering from hypercapnic acute respiratory failure: a physiological crossover trial. Crit Care Med, 47.

Majumder, A., & Basu, S. (2019). Guillain–barré syndrome developing in a patient with graves’ disease. Journal of the ASEAN Federation of Endocrine Societies, 34(1), 103–106. https://doi.org/10.15605/jafes.034.01.17

Mariotte, E., Azoulay, E., Galicier, L., Rondeau, E., Zouiti, F., Boisseau, P., Poullin, P., de Maistre, E., Provôt, F., Delmas, Y., Perez, P., Benhamou, Y., Stepanian, A., Coppo, P., & Veyradier, A. (2016). Epidemiology and pathophysiology of adulthood-onset thrombotic microangiopathy with severe ADAMTS13 deficiency (thrombotic thrombocytopenic purpura): A cross-sectional analysis of the French national registry for thrombotic microangiopathy. The Lancet Haematology, 3(5), e237–e245. https://doi.org/10.1016/S2352-3026(16)30018-7

Melone, M.-A., Heming, N., Meng, P., Mompoint, D., Aboab, J., Clair, B., Salomon, J., Sharshar, T., Orlikowski, D., Chevret, S., & Annane, D. (2020). Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial. Annals of Intensive Care, 10(1), 128. https://doi.org/10.1186/s13613-020-00742-z

Mishra, D., Sai, K., & Tiwari, K. (2017). Guillain-Barré Syndrome (GBS) – AN ORPHAN DISEASE. World Journal of Pharmaceutical Research, 6, 400. https://doi.org/10.20959/wjpr20175-8325

Nicolotti, D., Bignami, E. G., Rossi, S., & Vezzani, A. (2021). A case of thrombotic thrombocytopenic purpura associated with COVID-19. Journal of Thrombosis and Thrombolysis, 52(2), 468–470. https://doi.org/10.1007/s11239-020-02362-7

Ottaviani, D., Boso, F., Tranquillini, E., Gapeni, I., Pedrotti, G., Cozzio, S., Guarrera, G. M., & Giometto, B. (2020). Early Guillain-Barré syndrome in coronavirus disease 2019 (COVID-19): a case report from an Italian COVID-hospital. Neurological Sciences, 41(6), 1351–1354. https://doi.org/10.1007/s10072-020-04449-8

Rashid, A., Kurra, S., & Lavelle, W. (2017). Guillain-Barre syndrome after revision lumbar surgery: a case report. Cureus, 9. https://doi.org/10.7759/cureus.1393

Scheidl, E., Canseco Diez, D., Hadji-Naumov, A., & Bereznai, J. (2020). Guillain-Barré syndrome during SARS-CoV-2 pandemic: a case report and review of recent literature. J Peripher Nerv Syst, 25. https://doi.org/10.1111/jns.12382

Setiari, T. D., & Sudjud, R. W. (2018). Sindroma Guillain-Barre dengan Hospital Acquired Pneumonia di Unit Perawatan Intensif. Anesthesia & Critical Care, 36(3), 122–127.

Sukumar, S., Lämmle, B., & Cataland, S. R. (2021). Thrombotic Thrombocytopenic Purpura: Pathophysiology, Diagnosis, and Management. In Journal of Clinical Medicine (Vol. 10, Issue 3). https://doi.org/10.3390/jcm10030536

Walgaard, C., Lingsma, H. F., & Doorn, P. A. (2017). Tracheostomy or not: prediction of prolonged mechanical ventilation in Guillain–Barré Syndrome. Neurocrit Care, 26. https://doi.org/10.1007/s12028-016-0311-5

Wang, Y., Ni, Y., Sun, J., & Liang, Z. (2020). Use of high-flow nasal cannula for immunocompromise and acute respiratory failure: a systematic review and meta-analysis. J Emerg Med, 58.

Wen, P., Wang, L., Liu, H., Gong, L., Ji, H., Wu, H., & Chu, W. (2021). Risk factors for the severity of Guillain-Barré syndrome and predictors of short-term prognosis of severe Guillain-Barré syndrome. Scientific Reports, 11(1), 11578. https://doi.org/10.1038/s41598-021-91132-3

Wu, X., Wang, H., Xie, G., Lin, S., & Ji, C. (2022). Increased systemic immune-inflammation index can predict respiratory failure in patients with Guillain-Barré syndrome. Neurological Sciences, 43(2), 1223–1231. https://doi.org/10.1007/s10072-021-05420-x

Yadav, N., Pragati, & Dwivedi, M. K. (2022). Microorganisms in Pathogenesis and Management of Guillain–Barré Syndrome (GBS) BT - Role of Microorganisms in Pathogenesis and Management of Autoimmune Diseases: Volume II: Kidney, Central Nervous System, Eye, Blood, Blood Vessels & Bowel (M. K. Dwivedi, A. Sankaranarayanan, E. H. Kemp, & Y. Shoenfeld (eds.); pp. 177–194). Springer Nature Singapore. https://doi.org/10.1007/978-981-19-4800-8_9.

Published
2024-05-19
How to Cite
Harlasgunawan, A. R., Palo, D., Abdullah, D., Priambodo, A. P., & Mirwanti, R. (2024). Cross-Reactivity of Guillain-Barre Syndrome and Thrombotic Thrombocytopenic Purpura with Complications Respiratory Failure: Case Report. Indonesian Journal of Global Health Research, 6(5), 2413-2420. https://doi.org/10.37287/ijghr.v6i5.3441

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