Malignancy in Guillain-Barré syndrome: A twelve-year single-center study

Fu Liong Hiew, Yusuf Rajabally*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

The relationship between Guillain-Barré syndrome (GBS) and malignancy is uncertain. We retrospectively analyzed data of 118 consecutive patients admitted with GBS from Birmingham, U.K. (2001 − 2012). We calculated relative cancer risk using different definitions and determined characteristics of malignancy-associated GBS. Malignancy was globally commoner in our GBS cohort compared to the general population (odds ratio: 2.08; CI: 1.06–3.71; p = 0.036). However, this was unconfirmed if paraneoplastic criteria were applied. GBS patients with cancer were significantly more likely to be older (p = 0.043), hyponatremic (p = 0.037) and demonstrate more axonal loss (p < 0.05). Cerebrospinal fluid (CSF) protein levels were lower in the malignancy group (p = 0.002) and neurological improvement less likely (p = 0.023). In-patient mortality was significantly higher in patients with malignancy (p < 0.01). We conclude global cancer risk is higher in GBS than in the general population, although definition-dependent. Malignancy requires consideration in elderly, hyponatremic subjects with normal CSF protein, severe axonal loss, who fail to improve post-treatment.

Original languageEnglish
Pages (from-to)275-278
Number of pages4
JournalJournal of the Neurological sciences
Volume375
Early online date9 Feb 2017
DOIs
Publication statusPublished - 9 Feb 2017

Bibliographical note

© 2017, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International

Keywords

  • Axonal
  • Cancer
  • Guillain-Barré syndrome
  • Hyponatremia
  • Malignancy
  • Paraneoplastic

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