Organic arsenic-induced Guillain-Barré-like syndrome due to melarsoprol: A clinical, electrophysiological, and pathological study
| Autor: | Alain Astier, Annette Schaeffer, Christian Brun-Buisson, Josette Verroust, Muriel Vanderstigel, Denis Malapert, Patrick Chariot, Romain K. Gherardi |
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| Rok vydání: | 1990 |
| Předmět: |
Wallerian degeneration
Pathology medicine.medical_specialty Guillain-Barre syndrome Physiology business.industry Arsenic poisoning Melarsoprol medicine.disease Spinal cord Surgery Cellular and Molecular Neuroscience medicine.anatomical_structure Peripheral neuropathy Anterior Horn Cell Physiology (medical) medicine Neurology (clinical) business Polyneuropathy medicine.drug |
| Zdroj: | Muscle & Nerve. 13:637-645 |
| ISSN: | 0148-639X |
| DOI: | 10.1002/mus.880130713 |
| Popis: | A young woman suffering from sleeping sickness was treated with melarsoprol. Thirty-eight days after the first administration of this organo-arsenic compound, myalgias, distal paresthesias and rapidly progressive weakness developed in all four limbs. Electrophysiological studies were misleading for Guillain-Barre syndrome. Neuropathological data included massive distal wallerian degeneration in peripheral nerves and abnormalities in dorsal ganglia and spinal cord where vacuolation of anterior horn cells and axonal neurofilamentous masses were observed. Very high concentrations of arsenic were found in the spinal cord, contrasting with undetectable levels in peripheral nerves. Our findings are consistent with an arsenic neuronopathy manifested by initial proximal demyelination and delayed distal axonal damage. Renal and hepatic dysfunctions, which were implicated in the toxic arsenic accumulation, should be systematically detected before administration of melarsoprol. The diagnosis of Guillain-Barre syndrome must be considered with caution in patients treated with this compound. |
| Databáze: | OpenAIRE |
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