Muscle Nerve. 2022 Mar 27. doi: 10.1002/mus.27539. Online ahead of print.
ABSTRACT
INTRODUCTION/AIMS: Guillain-Barré syndrome (GBS) is generally considered to be monophasic, but some patients experience recurrences. The purpose of this study was to clarify the possible link between thyroid parameters and recurrent GBS (RGBS) patients in China.
METHODS: This retrospective study enrolled patients who were admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from 2014 to 2020 and fulfilled the diagnostic criteria of GBS or Miller Fisher syndrome (MFS). We evaluated clinical characteristics, cerebrospinal fluid (CSF) parameters, serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) in 320 individuals, including 302 with monophasic GBS and 18 with recurrent GBS.
RESULTS: Serum levels of TSH in monophasic GBS patients were significantly lower than those in RGBS patients (P<0.001), whereas FT3 levels were higher in the monophasic GBS group (P=0.022). Age at onset, incidence of antecedent illness, time from onset to nadir, proportion of acute inflammatory demyelinating polyradiculoneuropathy (AIDP), and Hughes Functional Grading Scale (HFGS) at nadir were statistically significant between monophasic GBS patients and RGBS patients (P<0.05). The multivariate regression analysis revealed that antecedent illness, AIDP and high TSH were independent risk factors for RGBS. Our ROC curve analysis showed that the risk of recurrence in GBS patients increases when the TSH concentration is higher than 3.87uIU/mL.
DISCUSSION: Our results demonstrate an association between TSH and RGBS. Oxidative stress is one of the possible interpretations for this association.
PMID:35342963 | DOI:10.1002/mus.27539
