Skip to main content

Advertisement

Log in

Late-onset cytomegalovirus infection complicated by Guillain–Barre syndrome in a kidney transplant recipient: case report and review of the literature

  • Case Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Cytomegalovirus (CMV) infection remains a common infection after solid-organ transplantation. In the general population CMV disease is associated with Guillain–Barre syndrome (GBS), an autoimmune disease leading to an acute peripheral neuropathy, in 1 of 1000 cases. Interestingly, GBS is a rarely observed complication in solid-organ transplant recipients, possibly related to maintenance immunosuppression. We describe a case of CMV infection complicated by GBS in a kidney transplant recipient and review the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. Arthurs SK, Eid AJ, Pedersen RA, et al. Delayed-onset primary cytomegalovirus disease and the risk of allograft failure and mortality after kidney transplantation. Clin Infect Dis. 2008;46:840–6.

    Article  PubMed  Google Scholar 

  2. Harvala H, Stewart C, Muller K, et al. High risk of cytomegalovirus infection following solid organ transplantation despite prophylactic therapy. J Med Virol. 2013;85:893–8.

    Article  CAS  PubMed  Google Scholar 

  3. Hammond SP, Martin ST, Roberts K, et al. Cytomegalovirus disease in lung transplantation: impact of recipient seropositivity and duration of antiviral prophylaxis. Transpl Infect Dis. 2013;15:163–70.

    Article  CAS  PubMed  Google Scholar 

  4. Mendez-Eirin E, Paniagua-Martín MJ, Marzoa-Rivas R, et al. Cumulative incidence of cytomegalovirus infection and disease after heart transplantation in the last decade: effect of preemptive therapy. Transplant Proc. 2012;44:2660–2.

    Article  CAS  PubMed  Google Scholar 

  5. Kuwabara S. Guillain-Barré syndrome. Curr Neurol Neurosci Rep. 2007;7:57–62.

    Article  CAS  PubMed  Google Scholar 

  6. Orlikowski D, Porcher R, Sivadon-Tardy V, et al. Guillain-Barré syndrome following primary cytomegalovirus infection: a prospective cohort study. Clin Infect Dis. 2011;52:837–44.

    Article  PubMed  Google Scholar 

  7. De Maar EF, Kas-Deelen DM, de Jager AE, et al. Inflammatory demyelinating polyneuropathy in a kidney transplant patient with cytomegalovirus infection. Nephrol Dial Transplant. 1999;14:2228–30.

    Article  PubMed  Google Scholar 

  8. El-Sabrout RA, Radovancevic B, Ankoma-Sey V, Van Buren CT. Guillain-Barré syndrome after solid organ transplantation. Transplantation. 2001;71:1311–6.

    Article  CAS  PubMed  Google Scholar 

  9. Keithi-Reddy SR, Chakravarthi RM, Hussaini SM, Venkatapuram RR, Murthy JM. Cytomegalovirus disease with Guillain-Barré syndrome in a cadaver renal allograft recipient: cause or coincidence. Int Urol Nephrol. 2007;39:967–70.

    Article  PubMed  Google Scholar 

  10. Garcia AT, García HA, Mazuecos BA, Lancho NC. Guillain-Barre syndrome in kidney transplant. Nefrologia. 2010;30:260–1.

    Google Scholar 

  11. Hodowanec AC, Simon DM. Late primary cytomegalovirus infection presenting with acute inflammatory demyelinating polyneuropathy in a heart transplant recipient. Transpl Infect Dis. 2012;14:E116–20.

    Article  CAS  PubMed  Google Scholar 

  12. Yuki N, Kuwabara S. Axonal Guillain-Barré syndrome: carbohydrate mimicry and pathophysiology. J Peripher Nerv Syst. 2007;12:238–49.

    Article  CAS  PubMed  Google Scholar 

  13. Hafer-Macko CE, Sheikh KA, Li CY, et al. Immune attack on the Schwann cell surface in acute inflammatory demyelinating polyneuropathy. Ann Neurol. 1996;39:625–35.

    Article  CAS  PubMed  Google Scholar 

  14. Sawai S, Satoh M, Mori M, et al. Moesin is a possible target molecule for cytomegalovirus-related Guillain-Barré syndrome. Neurology. 2014;83:113–7.

    Article  CAS  PubMed  Google Scholar 

  15. Suthanthiran M, Morris RE, Strom TB. Immunosuppressants: cellular and molecular mechanisms of action. Am J Kidney Dis. 1996;28:159–72.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Natasha Ethier for her assistance with the figure design.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. M. Knoll.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shaban, E., Gohh, R. & Knoll, B.M. Late-onset cytomegalovirus infection complicated by Guillain–Barre syndrome in a kidney transplant recipient: case report and review of the literature. Infection 44, 255–258 (2016). https://doi.org/10.1007/s15010-015-0819-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-015-0819-1

Keywords

Navigation