MUSCLE PATHOLOGY IN THE EARLY-STAGE OF GUILLAIN-BARRE-SYNDROME

Although many studies have been performed on nervous tissue pathology in Guillain-Barre syndrome (GBS), much less is known about pathologica l changes in skeletal muscle in this disorder. We have studied muscle biopsies from 5 patients with GBS, 5 patients with amyotrophic lateral sclerosis (control A), and 5 patients with polyarteritis nodosa (cont rol B). We also examined muscle obtained after death from 7 patients w ithout neurologic or muscular diseases (control C). By light microscop y, all specimens from patients with GBS exhibited necrosis and/or phag ocytosis, none of which was observed in the other three controls. Neit her small angulated fibers nor small group atrophy was found in patien ts with GBS and in control C, by contrast with controls A and B. Ultra structurally, filamentous bodies, subsarcolemmal aggregates of mitocho ndria, accumulation of glycogen particles, and concentric laminated bo dies were present much more frequently in patients with GBS than in al l controls. Only GBS patients showed cytoplasmic bodies. These observa tion suggests that there is muscle involvement in the early stage of G BS and that these muscle changes may have an intimate and important re lationship to the pathogenesis of GBS.