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Open Access Highly Accessed Case report

Guillain–Barré syndrome presenting with Raynaud’s phenomenon: a case report

Sonali Sihindi Chapa Gunatilake* and Harith Wimalaratna

Author Affiliations

Teaching Hospital, Kandy, Sri Lanka

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BMC Neurology 2014, 14:174  doi:10.1186/s12883-014-0174-3

Published: 3 September 2014

Abstract

Background

Guillain–Barré syndrome is an immune mediated acute inflammatory polyradiculo-neuropathy involving the peripheral nervous system. Commonest presentation is acute or subacute flaccid ascending paralysis of limbs. Rarely autonomic dysfunction can be the presenting feature of Guillain–Barré syndrome. Raynaud’s phenomenon, although had been described in relation to many disease conditions, has not been described in association with Guillain–Barré syndrome up to date.

Case presentation

We report the first case of Guillain–Barré syndrome presenting with Raynaud’s phenomenon in a 21-year-old previously well boy. New onset Raynaud’s phenomenon was experienced followed by acute ascending flaccid paralysis of lower limbs and upper limbs together with palpitations and postural giddiness. Nerve conduction studies showed acute inflammatory demyelinating polyneuropathy with cerebrospinal fluid cyto-protein dissociation. He was treated with intravenous immunoglobulin and showed a satisfactory clinical recovery of muscle weakness, Raynaud’s phenomenon and autonomic disturbances.

Conclusion

Guillain–Barré syndrome presenting with Raynaud’s phenomenon is not being reported in literature previously. Although the underlying mechanism is not fully understood, Raynaud’s phenomenon should prompt the physician to consider Guillain–Barré syndrome with a complimentary clinical picture.

Keywords:
Guillain–Barré syndrome; Raynaud’s phenomenon; Acute inflammatory demyelinating polyneuropathy; Cerebrospinal fluid; Cyto-protein dissociation; Acute ascending flaccid paralysis