Guillain-Barre syndrome after solid organ transplantation

Background Neurological complications occur frequently in solid organ trans plant recipients. However, the peripheral nerves are usually spared signifi cant toxicity. Guillain Barre syndrome (GBS) is the most common cause of ac ute neuropathy in adults. Despite numerous reports of GBS in recipients of bone marrow transplants, GBS has rarely been reported in recipients of soli d organ transplants. Recent evidence supports the role of the immune system in initiating and perpetuating the ongoing neural damage in this entity. I nfectious agents may initiate the immune attack, and the association of GBS with cytomegalovirus (CMV) infection has been studied extensively. Methods. To alert clinicians to the occurrence of GBS in the latter setting , we report five new cases of GBS after solid organ transplant and summariz e five other cases previously reported in the literature. Results, The GBS cases (published anal unpublished) have much in common: ah the patients were men, most had evidence of active CMV infection at or bef ore the onset of GBS, and all but one developed GBS within 1 year after tra nsplantation (range 1-26 months). Conclusion. The association of GBS with cytomegalovirus (CMV) infection in the nontransplant population and evidence of CMV infection in almost all re ported cases of GBS in solid organ transplant recipients suggest that CMV m ay have a role in triggering this illness.