Reversible stress cardiomyopathy in Guillain-Barré syndrome: a case report

J Med Case Rep. 2019 May 20;13(1):150. doi: 10.1186/s13256-019-2085-9.

Abstract

Background: Guillain-Barré syndrome is an autoimmune disorder in which autoantibodies mainly affect the peripheral nervous system. Autonomic dysfunction is a common and severe complication of Guillain-Barré syndrome. Cardiomyopathy, though, is a rare complication in Guillain-Barré syndrome, with only a few cases reported in the literature.

Case presentation: We present a case of a 65-year-old Greek woman with Guillain-Barré syndrome who developed cardiomyopathy shortly after admission to the intensive care unit due to respiratory deterioration. Her estimated left ventricular ejection fraction upon admission was 20%. The result of coronary angiography was negative for coronary artery disease, and cardiac magnetic resonance imaging excluded myocarditis. Her clinical condition improved with supportive therapy, and her estimated left ventricular ejection fraction at discharge was normal.

Conclusions: Clinicians should be aware of this potentially lethal complication of Guillain-Barré syndrome and the therapeutic options, because early diagnosis can improve prognosis. Routine electrocardiographic and echocardiographic assessments should be performed in patients with Guillain-Barré syndrome presenting with hemodynamic instability.

Keywords: Cardiomyopathy; Guillain-Barré syndrome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Cardiotonic Agents / therapeutic use
  • Dobutamine / therapeutic use
  • Echocardiography
  • Female
  • Furosemide / therapeutic use
  • Guillain-Barre Syndrome / complications
  • Guillain-Barre Syndrome / diagnosis
  • Guillain-Barre Syndrome / drug therapy
  • Guillain-Barre Syndrome / physiopathology*
  • Humans
  • Ramipril / therapeutic use
  • Respiratory Insufficiency / drug therapy
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / physiopathology*
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / drug therapy
  • Takotsubo Cardiomyopathy / etiology
  • Takotsubo Cardiomyopathy / physiopathology*
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Cardiotonic Agents
  • Dobutamine
  • Furosemide
  • Ramipril