Volume 6 Issue 1
Jan.  2015
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Hong-zhi GUAN, Lin CHEN, Li-ying CUI, Yu-zhou GUAN, Xiu-li LI, Min QIAN, Hai-tao REN, Yan-huan ZHAO. Cytological Features of Cerebrospinal Fluid in Guillain-Barré Syndrome and Their Diagnostic Value[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(1): 14-17. doi: 10.3969/j.issn.1674-9081.2015.01.003
Citation: Hong-zhi GUAN, Lin CHEN, Li-ying CUI, Yu-zhou GUAN, Xiu-li LI, Min QIAN, Hai-tao REN, Yan-huan ZHAO. Cytological Features of Cerebrospinal Fluid in Guillain-Barré Syndrome and Their Diagnostic Value[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(1): 14-17. doi: 10.3969/j.issn.1674-9081.2015.01.003

Cytological Features of Cerebrospinal Fluid in Guillain-Barré Syndrome and Their Diagnostic Value

doi: 10.3969/j.issn.1674-9081.2015.01.003
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  • Corresponding author: CUI Li-ying Tel: 010-69156377, E-mail:pumchcuily@sina.com
  • Received Date: 2014-01-22
  • Publish Date: 2015-01-30
  •   Objective  To investigate the cytological features of cerebrospinal fluid (CSF) in Guillain-Barré syndrome (GBS) and the role of the cytological features in the diagnosis of GBS.  Methods  We reviewed the clinical, neurophysiological, and CSF cytological findings of GBS patients treated in Peking Union Medical College Hospital from January 2010 to December 2012. The included patients all met the diagnostic criteria in 2010 China Guidelines for Diagnosis and Treatment of GBS. CSF cytological tests were performed using sedimentation chamber and MGG staining. CSF routine cell count and CSF cytological-finding positive-rate were compared with Chi-square test.  Results  Twenty-eight cases of GBS were included, at a mean age of 39 years (8-69 years), including 19 males and 9 females. The 28 patients all had acute onset, with 22 demonstrating limb weakness, 13 hypoesthesia, 3 hyperesthesia, 7 bulbar paralysis, 3 with the need of assisted ventilation, 5 urinary retention, 1 positional hypotension, 5 ophthalmoplegia, 10 facial paralysis, and 4 ataxia. The patients were clinically classified to acute inflammatory demyelinating polyneuropathy (20 cases), acute motor axonal neuropathy(1 case), acute motor-sensory axonal neuropathy (1 case), acute sensory neuropathy (1 case), Miller Fisher syndrome (4 cases), and GQ1b antibody-positive ophthalmoplegia (1 case). CSF protein was 0.39-4.23 g/L, increased in 26 cases, and >1.0 g/L in 11 cases. CSF white blood cell count was 0×106-5×106/L in 26 cases, and 6×106-10×106/L in 2 cases. Oligoclonal band test of CSF produced positive results in 14 cases, and myelin basic protein was found increased in 18. Anti-GM1 antibodies were positive in 3 cases and anti-GQ1b antibodies in 2 cases. Abnormal CSF cytological results were found in 12 patients, including lymphocytic inflammation in 9 and monocyte-lymphocytic inflammation in 3. The percentage of neutrophils reached 2% in 1 case. Activated lymphocytes were present in 6 cases, activated mononuclear macrophages in 2, and plasma cells in 3. The CSF cell count was over 5/μl in 2 patients (7.1%), significantly lower than the positive rate of CSF cytological test (12 cases, 42.9%, P < 0.01).  Conclusions  CSF cytological test in GBS could detect inflammatory changes such as lymphocyte inflammation, consistent with the pathological mechanism of polyradiculitis in GBS. Compared with CSF routine cell count, cytological test is more sensitive in revealing the inflammatory status of CSF, showing larger diagnostic value for GBS.
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  • [1] 中国吉兰-巴雷综合征诊治指南[J].中华神经科杂志, 2010, 43: 583-586.
    [2] Asbury AK, Arnason BG, Adams RD. The inflammatory lesion in idiopathic polyneuritis[J]. Medicine, 1969, 48:173-215. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=WK_LWW2017052520133435
    [3] 关鸿志, 王长华, 郭玉璞, 等.脑脊液细胞学的特异性发现[J].中华神经科杂志, 2004, 37:65-67. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhsjk200401019
    [4] Kanda T, Hayashi H, Tanabe H, et al. A fulminant case of Guillain-Barré syndrome:topographic and fibre size related analysis of demyelinating changes[J]. J Neurol Neurosurg Psychiatry, 1989, 52:857-864. doi:  10.1136/jnnp.52.7.857
    [5] Fishman RA. Cerebrospinal fluid in diseases of the nervous system[M]. Philadelphia:Saunders, 1980:175-176.
    [6] 于素贞, 刘梅仕, 邓小梅, 等.多发性硬化和格林巴利综合征脑脊液细胞学及寡克隆区带测定的临床意义[J].脑与神经疾病杂志, 1994, 2:70-71. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=QK199500836825
    [7] 候熙德, 周善仁.临床脑脊液细胞学[M].南京:江苏科学技术出版社, 1985:1-120.
    [8] Kowarik MC, Grummel V, Wemlinger S, et al. Immune cell subtyping in the cerebrospinal fluid of patients with neurological diseases[J]. J Neurol, 2014, 261:130-143. doi:  10.1007/s00415-013-7145-2
    [9] Irani DN. Cerebrospinal fluid in clinical practice[M]. Philadelphia:Saunders, 2009:121-125.
    [10] Mateen FJ, Cornblath DR, Jafari H, et al. Guillain-Barré Syndrome in India:population-based validation of the Brighton criteria[J]. Vaccine, 2011, 29:9697-9701. doi:  10.1016/j.vaccine.2011.09.123
    [11] Rauschka H, Jellinger K, Lassmann H, et al. Guillain-Barré syndrome with marked pleocytosis or a significant proportion of polymorphonuclear granulocytes in the cerebrospinal fluid:neuropathological investigation of five cases and review of differential diagnoses[J]. Eur J Neurol, 2003, 10:479-486. doi:  10.1046/j.1468-1331.2003.00644.x
    [12] 关鸿志, 陈琳, 郭玉璞, 等.脑膜淋巴瘤的临床脑脊液细胞学研究[J].中华神经科杂志, 2006, 39:114-117. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhsjk200602011
    [13] 关鸿志, 陈琳, 梁智勇, 等.原发中枢神经系统淋巴瘤的脑脊液细胞学诊断[J].协和医学杂志, 2012, 3:273-278. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=xhyx201203006
    [14] Machida H, Shinohara T, Hatakeyama N, et al. CD5-positive diffuse large B cell lymphoma infiltrating the central nervous system presenting Guillain-Barré-like syndrome after chemotherapy[J]. J Clin Exp Hematop, 2012, 52:199-204. doi:  10.3960/jslrt.52.199
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