Objectives The clinical and epidemiological profiles of Guillain-Barré syndrome (GBS) in southern China have yet to be fully recognised. We aimed to investigate the subtypes of GBS in southern China, compare the clinical features of demyelinating form with that of axonal form and test whether preceding infections and age have influence on the clinical phenotype, disease course and severity of GBS.
Methods Medical records of patients with a diagnosis of GBS admitted to 31 tertiary hospitals, located in 14 provinces in southern China, from 1 January 2013 to 30 September 2016, were collected and retrospectively reviewed.
Results Finally. 1056 patients, including 887 classic GBS and 169 variants, were enrolled. The 661 classic patients with available electromyographic data were grouped as having acute inflammatory demyelinating polyneuropathy (AIDP, 49.0%), acute motor axonal neuropathy (AMAN, 18.8%), inexcitable (0.9%) and equivocal (31.3%). In contrast to AIDP, patients with AMAN were characterised by earlier nadir (P=0.000), higher Hughes score at nadir (P=0.003) and at discharge (P=0.000). Preceding upper respiratory infections were identified in 369 (34.9%) patients, who were more inclined to develop AIDP (P=0.000) and Miller-Fisher syndrome (P=0.027), whereas gastrointestinal infection were found in 89 (8.4%) patients, who were more prone to develop AMAN (P=0.000), with more severe illness (P=0.001) and longer hospital stay (P=0.009). Children (≤15 years) and the elderly (≥56 years) were more severe at nadir, the elderly had the longest hospital stay (P=0.023).
Conclusion AIDP is the predominant form in southern China, which is different from data of northern China. The different subtypes, preceding infection and age of onset can partially determine the disease progression, severity and short-term recovery speed of GBS.
Clinical trial registration ChiCTR-RRC-17014152.
Statistics from Altmetric.com
SL and ZX contributed equally.
Contributors ML, FJ, BS, HD, CL, BH, RZ, ZZ, JL, XL, JX, FH, CQ, LW, TL, RB, YC, HL, RZ, XW, YW, SR, XH, ZJ, HW, DY, WY, WL, DG and BC helped us to collect complete medical records and develop the research plan, and finally they involved in the diagnosis and discussion of complex patients. SL, ZX, YL, JY, YY, JG, MZ, XF, GG, HZ, MD, SF, QC, JL and ZL took part in validating the diagnosis and information extraction. SL, YL and JY typed the data in table and verified all the information. SL and ZX wrote the paper.
Funding This work was supported by grants from Wuhan Science and Technology Bureau scientific research project (2015060101010047). The sponsors played no role in the study design, data collection and analysis or decision to submit the article for publication.
Competing interests None declared.
Ethics approval This retrospective study was approved by the ethics committee of the Remin Hospital of Wuhan University, Wuhan, China. The informed consent was waived.
Provenance and peer review Not commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.