Occurrence of Guillain-Barré syndrome as an immune mediated complication after thrombolysis with streptokinase for acute anterior wall myocardial infarction: a caution to be vigilant.

Abstract

Guillain-Barré syndrome (GBS) constitutes a heterogeneous group of immune-mediated peripheral neuropathic disorders that can be triggered by a variety of antecedent events. Clinical symptoms are thought to result from streptokinase antibody-mediated damage to the local blood-nerve barrier. We report the case of a 50-year-old man with acute anterior wall myocardial infarction who developed GBS as a manifestation of autoimmune hypersensitivity reaction to the drug 17 days after thrombolytic therapy with streptokinase. The patient was treated with a 5-day course of intravenous γ globulin and his symptoms improved and there was no residual deficit. The case forms a reminder of the autoimmune complications of non-fibrin specific agents that can sometimes be catastrophic and require persistent and vigilant in-hospital and immediate postdischarge follow-up and immediate management.

• Authors: Basant Kumar, Navin Agrawal, Soumya Patra, C N Manjunath
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2013 (Oct 07 2013) ISSN: 1757-790X [Electronic] England
• PMID: 24099761 (Publication Type: Case Reports, Journal Article)

Chemical References

• Fibrinolytic Agents
• Immunologic Factors
• gamma-Globulins
• Streptokinase

Topics

• Anterior Wall Myocardial Infarction (drug therapy)
• Fibrinolytic Agents (adverse effects)
• Guillain-Barre Syndrome (chemically induced, immunology)
• Humans
• Immunization, Passive
• Immunologic Factors (therapeutic use)
• Male
• Middle Aged
• Streptokinase (adverse effects)
• gamma-Globulins (therapeutic use)