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Takotsubo cardiomyopathy in Guillain–Barré syndrome

  • Original Communication
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Abstract

Background and purpose

Takotsubo cardiomyopathy (TCM) is a serious autonomic complication of Guillain–Barré syndrome (GBS). However, the association between TCM and GBS has not been investigated in detail. We investigated the characteristics of GBS patients with TCM (GBS-TCM).

Methods

Clinical features and anti-ganglioside antibody between the GBS-TCM patients and 62 classical GBS patients without TCM as control patients were compared.

Results

Eight GBS-TCM patients were identified, in whom TCM was diagnosed at a mean of 6.5 [range 3–42] days after the onset of GBS. The age at onset of GBS was elder in the GBS-TCM patients than in the control GBS patients (76.5 [56–87] vs. 52 [20–88] years, p < 0.01). Notably, cranial nerve deficits, particularly in the lower cranial nerves, were observed in all GBS-TCM patients (100% vs. 41.9%, p < 0.01). Additionally, the GBS-TCM patients showed a higher GBS disability score at nadir (5 [4–5] vs. 4 [1–5], p < 0.01), and lower Medical Research Council sum scores at admission and nadir (37 [30–44] vs. 48 [12–60] at admission, p < 0.05, and 20 [12–44] vs. 40 [0–60] at nadir, p < 0.05, respectively). Mechanical ventilation was more frequently required in the GBS-TCM patients (62.5% vs. 11.3%, p < 0.01). Three GBS-TCM patients were positive for anti-ganglioside antibodies.

Conclusions

TCM occurred at a relatively early phase of GBS. The characteristics of GBS-TCM were the elder, lower cranial nerve involvements, severe limb weakness, and respiratory failure.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors also thank Rie Tanaka and Yukiko Watanabe for technical assistance. We thank Popiel Helena Akiko for English langage editing.

Funding

This work was supported by JSPS KAKENHI (20K07894 to M. Kuwahara).

Author information

Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, Kindai University, Osaka, Japan

    Atsushi Terayama, Motoi Kuwahara, Keisuke Yoshikawa, Yuko Yamagishi, Makoto Samukawa, Shoko Yamashita, Susumu Kusunoki & Yoshitaka Nagai

  2. Department of Cardiology, Faculty of Medicine, Kindai University, Osaka, Japan

    Kyohei Onishi

  3. Division of Cardiology, Kiwa Hospital, Wakayama, Japan

    Tomoya Nagano

  4. Department of Neurology, Japan Community Healthcare Organization Hoshigaoka Medical Center, Osaka, Japan

    Chikao Tatsumi

  5. Department of Neurology, Kobe City Medical Center General Hospital, Hyogo, Japan

    Junko Ishii & Michi Kawamoto

  6. Division of Neurology, National Hospital Organization Okinawa National Hospital, Okinawa, Japan

    Takashi Tokashiki

  7. Department of Neurology, Okayama City Hospital, Okayama, Japan

    Shoko Deguchi & Kentaro Deguchi

  8. Department of Neurology, Showa University Fujigaoka Hospital, Kanagawa, Japan

    Atsushi Ishida & Yasuhiko Baba

  9. Department of Neurology, Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan

    Shigeki Yamaguchi

  10. Japan Community Health Care Organization Headquarters, Tokyo, Japan

    Susumu Kusunoki

Authors
  1. Atsushi Terayama
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  2. Motoi Kuwahara
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  3. Keisuke Yoshikawa
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Contributions

Conceptualization: AT and MK; data curation: AT, KY, YY, MS, SY, KO, TN, CT, JI, MK, TT, SD, KD, AI, YB, and SY; formal analysis: AT, MK, KY, and SK; funding acquisition: MK; writing the original draft: AT and MK; writing editing: SK, and YN; supervision: MK, SK, and YN.

Corresponding author

Correspondence to Motoi Kuwahara.

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Conflict of interest

Financial intersts: M. Kuwahara has served as a honoraria speaker for CSL Behring, Japan Blood Product Organization, and Takeda Pharmaceuticals. S. Kusunoki received speech honoraria from Takeda, Japan Blood Product Organization, and CSL Behring and served on the DSMB for Argenx and received consulting fees as a medical expert from KM Biologics. Non-financial intersts: none.

Ethical approval

This study conformed with the World Medical Association Declaration of Helsinki and was approved by the Internal Review Board of Kindai University Faculty of Medicine.

Informed consent

All participants provided written informed consent.

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Terayama, A., Kuwahara, M., Yoshikawa, K. et al. Takotsubo cardiomyopathy in Guillain–Barré syndrome. J Neurol (2024). https://doi.org/10.1007/s00415-024-12295-3

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  • DOI: https://doi.org/10.1007/s00415-024-12295-3

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