Variant of Guillain-Barré syndrome with anti-sulfatide antibody positivity and spinal cord involvement: A case report

Abstract

BACKGROUND

Guillain-Barré syndrome (GBS) is an acute autoimmune-mediated polyneuropathy. Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patients with GBS. However, spinal cord involvement is relatively rare in these cases.

CASE SUMMARY

A 68-year-old woman was admitted to the hospital with weakness of the limb for more than 3 d. Additional symptoms included neck pain, progressive numbness in the distal extremities, urinary and fecal retention, and reduced perception of temperature. She was diagnosed with an anti-sulfatide antibody-positive GBS variant and discharged after treatment with methylprednisolone and intravenous human immunoglobulin pulse therapy. Unlike common cases of anti-sulfatide antibody-positive GBS, this patient had atypical clinical symptoms of spinal cord involvement. No similar cases have previously been reported in China.

CONCLUSION

Although GBS is associated with a poor prognosis, a prompt diagnosis allows early administration of combined intravenous human immunoglobulin and methylprednisolone pulse therapy.

Keywords: Guillain-Barré syndrome; spinal cord involvement; anti-sulfatide antibody-positive; Case report

Core Tip: Guillain-Barré syndrome (GBS) is an autoimmune-mediated acute polyneurogenic neuropathy. The clinical presentation of GBS is characterized by an acute onset, symmetric limb weakness, sensory disturbances, extraocular muscle paralysis, ataxia, diminished tendon reflexes, hypotonia, abdominal distention, constipation, and urinary retention following autonomic nerve damage. In recent years, anti-sulfatide antibody positivity has been increasingly noted in GBS cases, with varying clinical symptoms; thus, these antibodies have become crucial for the diagnosis of GBS. Here, we report the case of a patient who presented with signs and symptoms of spinal cord involvement and was diagnosed with anti-sulfatide antibody-positive GBS combined with spinal cord involvement, which is relatively rare in clinical practice; the symptoms improved after receiving combined treatment with intravenous human immunoglobulin and methylprednisolone pulse therapy.