Guillain-Barré Syndrome Presenting with Sinus Node Dysfunction and Refractory Shock

Department

Internal Medicine

Document Type

Article

Publication Title

The American Journal of Case Reports

Abstract

BACKGROUND Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that is usually associated with preceding respiratory or gastrointestinal infection and has the hallmark manifestation of ascending flaccid paralysis. We report an atypical presentation of GBS. CASE REPORT A 76-year-old male presented with acute onset of diaphoresis and altered mental status. He subsequently developed severe bradycardia and refractory hypotension, which initially responded to dopamine infusion. A temporary pacemaker wire was placed to stabilize the heart rate but hypotension persisted. Acute autonomic dysfunction was suspected. Head and chest imaging was unrevealing. Lumbar puncture revealed albuminocytologic dissociation that was consistent with a diagnosis of GBS. Hospital course was complicated with acute kidney injury and metabolic acidosis. Plasmapharesis was initiated. The patient eventually died of multi-organ failure. CONCLUSIONS Autonomic dysfunction is a known but rare presentation of GBS. In patients presenting with refractory bradycardia and hypotension, GBS should be considered in the differential diagnosis.

First Page

251

Last Page

254

DOI

10.12659/ajcr.902668

Volume

18

Publication Date

3-11-2017

Medical Subject Headings

Aged; Fatal Outcome; Guillain-Barre Syndrome (complications, diagnosis); Humans; Male; Multiple Organ Failure (etiology); Sick Sinus Syndrome (etiology)

PubMed ID

28283677

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