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Bladder dysfunction and hypertension in children with Guillain–Barre syndrome

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Abstract

Background

Guillain–Barre syndrome (GBS) causes acute motor, sensory and autonomic dysfunction. There is a relative paucity of published data regarding the autonomic features of GBS. The aims of this study were to describe the incidence, management and outcome of bladder dysfunction and hypertension in GBS and to ascertain whether these features relate to muscle weakness severity.

Case-Diagnosis/Treatment

Twenty-seven patients with a median (interquartile range) age of 5.7 (3.5–8.4) years were included, of whom 18 (67 %) were male and 14 (52 %) had autonomic dysfunction. One patient presented with and three subsequently developed urinary retention necessitating catheterisation for a median of 7.5 (7–14.5) days. Univariate analysis demonstrated that urinary retention was associated with weakness in all four limbs [retention: MRC muscle grade 2 (2–2.75); no retention: MRC grade 4 (3–4); p = 0.02], possibly reflecting more severe disease. Patients with hypertension (12 patients, 44 %) had a longer hospital stay [median 32.5 (15.5–53.5) days; rho = 0.65; p = 0.02], and those with worse muscle weakness required more anti-hypertensive medications (upper limb rho = −0.71, p = 0.03; lower limb rho = −0.72, p = 0.03]. The majority of blood pressure treatments involved calcium channel and beta blockers.

Conclusion

In children with GBS, bladder dysfunction and hypertension are common. The presence of severe muscle weakness may predict those at greatest risk of these complications.

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Authors and Affiliations

  1. Department of Paediatric Nephrology, Royal Manchester Children’s Hospital and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK

    Louise Watson, Nicholas D. Plant & Nicholas J. A. Webb

  2. Department of Paediatric Neurology, Royal Manchester Children’s Hospital, Manchester, UK

    Majid Aziz & Grace Vassallo

  3. Department of Paediatric Nephrology, Royal Manchester Children’s Hospital, Oxford Road, Manchester, UK, M13 9WL

    Louise Watson

Authors
  1. Louise Watson
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  2. Majid Aziz
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  3. Grace Vassallo
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  4. Nicholas D. Plant
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  5. Nicholas J. A. Webb
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Corresponding author

Correspondence to Louise Watson.

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Watson, L., Aziz, M., Vassallo, G. et al. Bladder dysfunction and hypertension in children with Guillain–Barre syndrome. Pediatr Nephrol 29, 1637–1641 (2014). https://doi.org/10.1007/s00467-014-2799-2

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  • DOI: https://doi.org/10.1007/s00467-014-2799-2

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