Guillain-Barré sendromunda mevsimsel özellikler ve klinik alt tiplerin 63 vakalık seride değerlendirilmesi

Yıl 2018, Cilt: 10 Sayı: 3, 284 - 288, 30.09.2018

Yeşim Güzey Aras , Belma Doğan Güngen

https://doi.org/10.21601/ortadogutipdergisi.332864

Öz

Amaç: Guillain–Barré sendromu (GBS)
akut yada subakut başlayabilen genellikle ilerleyici flask paralizi ile
seyreden inflamatuar demyelinizan poliradikülonöropatiler içerisinde yer alan
bir hastalıktır. Bu çalışmanın amacı kendi hasta grubumuzda GBS'nin mevsimlere
göre dağılımını, mevsimle  GBS alt
tipleri arasındaki  ilişkiyi ve mevsimle
prognoz arasındaki ilişkiyi  araştırmaktır.

Gereç ve Yöntem: Bu çalışmada 2007-2017 yılları arasında kliniğimizde
yatarak tedavi görmüş Asbury tanı kriterlerine göre kesin GBS tanısı almış erişkin hastaların dosyaları
retrospektif olarak  tarandı.Hastaların
 yaş, cinsiyet, geçirilmiş enfeksiyonlar, mevsimlere göre dağılımı, klinik
alt tipleri , hastanede kalış süreleri, Hughes Fonksiyonel Ölçeği Skoru (HFÖS),
yoğun bakım ihtiyaçları, entübasyon , 
mortalite durumları kaydedildi.

Bulgular:
Çalışmaya 63 hasta alındı. Hastaların 35'i erkek, 28'i kadındı.  Yaş ortalaması erkeklerde 51,4±18,2,
kadınlarda 47,07±18,9
idi. AIDP hastaların 37
(%58,7)'sinde,  AMAN
hastaların 8 (%12,7)'inde,
AMSAN hastaların 6 (%9,5)'sında,
Miller-Fisher Sendromu hastaların 5
(%7,9)'inde görüldü. GBS semptomları başlamadan önceki 2-4 haftada
hastaların 30 (%47,6)'unda
ÜSYE,  15 (%2,8)'inde GİS enfeksiyonu, 1 (%1,6)'inde
aşı öyküsü vardı. Mevsimsel dağılıma bakıldığında hastaların 13(%20,6)'ü
kış mevsiminde, 21 (%33,3)'i
ilkbaharda, 19 (%30,2)'u
yaz mevsiminde, 10 (%15,9)'u
sonbaharda idi. Mevsimsel dağılım ile klinik alt tipler arasındaki ilişkiye
bakıldığında AIDP formunda mevsimsel fark saptanmazken aksonal formlar ilkbahar
ve yaz mevsiminde diğer mevsimlere göre daha sık ortaya çıkmıştır. Hastaneye
ilk başvuru HFÖS ile mevsimsel dağılıma bakıldığında en düşük HFÖS ilkbaharda
saptandı.

Sonuç:
Çalışmamızda, GBS hastalarında aksonal form, ilkbahar ve yaz
mevsiminde daha sıktı. Buna ek olarak, ilkbaharda görülenler vakalarda prognoz
daha iyi iken kış aylarında daha kötüdür. Hastaların mevsimsel dağılımları
arasındaki ilişkinin daha fazla sayıda hasta ile değerlendirilmesi gerektiğini
düşünüyoruz.

Anahtar Kelimeler

Mevsim, GBS, prognoz

Seasonal characteristics and clinical treatment in the Guillaine-Barré syndrome 63 evaluation of the patient series

Öz

Background: Guillain-Barré
syndrome (GBS) is a disease that occurs with in the inflammatory demyelinating polyradiculoneuropathies
of the common flaccid paralysis that can begin in the acute or subacute stage. The aim of this study was to investigate the relationship
between seasonal distribution of GBS in our own patient group, the relationship
between seasonal GBS subtypes and seasonal prognosis.

Material and Method: This study retrospectively reviewed the files of
adult patients who were diagnosed as GBS-diagnosed according to Asbury diagnostic
criteria in our clinic between 2007 and 2017. Age, sex, past infections,
seasonal distribution, clinical subtypes, hospitalization times, Hughes Functional
Scale HFRS), intensive care needs, intubation, and mortality were recorded.

Results: Sixty-three patients were included in the study. The
patients were 35 males and 28 females. The mean age was 51.4 ± 18.2 in males and
47.07 ± 18.9 in females. In 37 (58.7%) of AIDP patients, 8 (12.7%) in AMAN
patients, 6 (9.5%) in AMSAN patients and 5 (7.9%) in Miller-Fisher syndrome patients
were found to be indent. Before the onset of GBS symptoms, there were 30
(47.6%) Upper respiratory tract infection patients, 15 (23.8%) indent GIS
infections, and 1 (1.6%) indent vaccination history at 2-4 weeks. When the seasonal
distribution was examined, 13 (20.6%) of the patients were in the winter, 21
(33.3%) were in the spring, 19 (30.2%) were in the summer and 10 (15.9%) were
in the autumn. Given the relationship between seasonal distribution and clinical
subtypes, no seasonal difference was found in AIDP form, where asaxonal forms appeared
more frequently in spring and summer than in other seasons. When the first application
to the hospital and the seasonal distribution with HFRS were taken, the lowest
HFRS was determined in the spring.

Conclusion: In
our study, axonal form in GBS patients was more frequent in spring and summer seasons.
In addition, those who are seen in the spring are better be haved and the treatment
is worse in the winter months while the treatment is better. We think that the relationship
between seasonal distributions of patients should be evaluated with higher number
of studies.

Anahtar Kelimeler

Season, GBS, prognozis

Kaynakça

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