A CASE-CONTROL STUDY OF DRUGS AND OTHER DETERMINANTS AS POTENTIAL CAUSES OF GUILLAIN-BARRE-SYNDROME

The Guillain-Barre syndrome is an inflammatory demyelinating polyneuro pathy with an acute or subacute onset. The current case-control study was performed to investigate the possible role of drugs and other dete rminants in the causation of the Guilfain-Barre syndrome. Patients wer e included as cases if they fulfilled the criteria for acute Guillain- Barre syndrome and were unable to walk 10 m independently and had been admitted to the hospital within 2 weeks of onset of the neuropathy. F or every case, two controls without the disease were obtained from the general practitioner (GP) of the patient with Guillain-Barre syndrome . Controls had the same type of health care insurance, were of the sam e gender and age (within 5 years), and resident in the same area. By t elephone, the GPs of the patients with Guillain-Barre syndrome were in terviewed. There were 71 female and 75 male cases and 142 female and 1 49 male controls. Significantly more cases than controls had been pres cribed drugs in the 3 months prior to the index date and also diagnose s or symptoms in cases were more common. Case patients used significan tly more frequently antipropulsives (loperamide), penicillins (amoxici llin with or without clavulanic acid) and vaccines. Female controls us ed significantly more often oral contraceptives. More cases than contr ols suffered from infections of the respiratory, gastrointestinal or u rinary tract prior to the onset of neurological symptoms. In a logisti c regression analysis, symptoms concerning the gastrointestinal and re spiratory system were strongly associated with the Guillain-Barre synd rome. The use of oral contraceptives was significantly lower in female cases which could be compatible with the hypothesis that these drugs are protective.