Journal of NeuroVirology

, Volume 23, Issue 3, pp 504–507 | Cite as

Guillain-Barre syndrome complicating chikungunya virus infection

  • Ayush Agarwal
  • Deepti Vibha
  • Achal Kumar Srivastava
  • Garima Shukla
  • Kameshwar Prasad
Case Report

Abstract

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus which presents with symptoms of fever, rash, arthralgia, and occasional neurologic disease. While outbreaks have been earlier reported from India and other parts of the world, the recent outbreak in India witnessed more than 1000 cases. Various systemic and rarely neurological complications have been reported with CHIKV. We report two cases of Guillain-Barré syndrome (GBS) with CHIKV. GBS is a rare neurological complication which may occur after subsidence of fever and constitutional symptoms by several neurotropic viruses. We describe two cases of severe GBS which presented with rapidly progressive flaccid quadriparesis progressing to difficulty in swallowing and breathing. Both required mechanical ventilation and improved partly with plasmapharesis. The cases emphasize on (1) description of the rare complication in a setting of outbreak with CHIKV, (2) acute axonal as well as demyelinating neuropathy may occur with CHIKV, (3) accurate identification of this entity during outbreaks with dengue, both of which are vector borne and may present with similar complications.

Keywords

Guillain-Barre syndrome Chikungunya virus Plasmapharesis Mosquito-borne diseases 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Chandak NH, Kashyap RS, Kabra D et al (2009) Neurological complications of chikungunya virus infection. Neurol India 57:177–180. doi: 10.4103/0028-3886.51289 CrossRefPubMedGoogle Scholar
  2. Facts about Chikungunya17806 - pdf. (2016b) http://nvbdcp.gov.in/Doc/Facts%20about%20Chikungunya17806.pdf. Accessed 3 Nov 2016
  3. Fujimura H (2013) The Guillain-Barré syndrome. Handb Clin Neurol 115:383–402. doi: 10.1016/B978-0-444-52902-2.00021-7 CrossRefPubMedGoogle Scholar
  4. Handler MZ, Handler NS, Stephany MP et al (2016) Chikungunya fever: an emerging viral infection threatening North America and Europe. Int J Dermatol. doi: 10.1111/ijd.13439 PubMedGoogle Scholar
  5. Lebrun G, Chadda K, Reboux A-H et al (2009) Guillain-Barré syndrome after chikungunya infection. Emerg Infect Dis 15:495–496. doi: 10.3201/eid1503.071482 CrossRefPubMedPubMedCentralGoogle Scholar
  6. Lewthwaite P, Vasanthapuram R, Osborne JC et al (2009) Chikungunya virus and central nervous system infections in children, India. Emerg Infect Dis 15:329–331. doi: 10.3201/eid1502.080902 CrossRefPubMedPubMedCentralGoogle Scholar
  7. Menon PR, C K, Sankar J, et al. (2010) A child with serious chikungunya virus (CHIKV) infection requiring intensive care, after an outbreak. Indian J Pediatr 77:1326–1328. doi:  10.1007/s12098-010-0174-2
  8. NVBDCP (2016a), National Vector Borne Disease Control Programme. In: Httpnvbdcpgovinchik-Cdhtml. http://nvbdcp.gov.in/chik-cd.html. Accessed 2 Nov 2016
  9. Oehler E, Fournier E, Leparc-Goffart I et al (2015) Increase in cases of Guillain-Barré syndrome during a chikungunya outbreak, French Polynesia, 2014 to 2015. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull 20:30079. doi: 10.2807/1560-7917.ES.2015.20.48.30079 Google Scholar
  10. Priya R, Khan M, Rao MK, Parida M (2014) Cloning, expression and evaluation of diagnostic potential of recombinant capsid protein based IgM ELISA for chikungunya virus. J Virol Methods 203:15–22. doi: 10.1016/j.jviromet.2014.03.005 CrossRefPubMedGoogle Scholar
  11. Sejvar JJ, Kohl KS, Gidudu J et al (2011) Guillain-Barré syndrome and Fisher syndrome: case definitions and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 29:599–612. doi: 10.1016/j.vaccine.2010.06.003 CrossRefPubMedGoogle Scholar
  12. Tilak R, Ray S, Tilak VW, Mukherji S (2016) Dengue, chikungunya and the missing entity—Zika fever: a new emerging threat. Med J Armed Forces India 72:157–163. doi: 10.1016/j.mjafi.2016.02.017 CrossRefPubMedPubMedCentralGoogle Scholar
  13. Wielanek AC, Monredon JD, Amrani ME et al (2007) Guillain-Barré syndrome complicating a chikungunya virus infection. Neurology 69:2105–2107. doi: 10.1212/01.wnl.0000277267.07220.88 CrossRefPubMedGoogle Scholar

Copyright information

© Journal of NeuroVirology, Inc. 2017

Authors and Affiliations

  1. 1.Neurosciences Center, Department of NeurologyAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations