Pediatric Guillain-Barré Syndrome in a 30-Year Nationwide Cohort

Lotte Sahin Levison; Reimar Wernich Thomsen; Lars Kjøbsted Markvardsen; Diana Hedevang Christensen; Søren Hein Sindrup; Henning Andersen

doi:10.1016/j.pediatrneurol.2020.01.017

Pediatric Guillain-Barré Syndrome in a 30-Year Nationwide Cohort

Lotte Sahin Levison^*, Reimar Wernich Thomsen, Lars Kjøbsted Markvardsen, Diana Hedevang Christensen, Søren Hein Sindrup, Henning Andersen

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

26 Citations (Scopus)

Abstract

Background: Guillain-Barré syndrome is the most common cause of acute flaccid paresis in childhood. Few validated large-scale population-based data are available concerning pediatric Guillain-Barré syndrome, including incidence, risk factors, and initial clinical characteristics. Methods: In the Danish National Patient Registry, we identified all children aged below 16 years (N = 212) diagnosed with Guillain-Barré syndrome and admitted to any Danish department of pediatrics between 1987 and 2016. A total of 145 (68%) medical files could be retrieved and reviewed, enabling classification of patients with true Guillain-Barré syndrome. The nationwide Guillain-Barré syndrome incidence rate was calculated and stratified by age, gender, time periods, and season. Risk factors and initial Guillain-Barré syndrome characteristics were assessed by medical record review. Results: The positive predictive value of Guillain-Barré syndrome diagnosis codes was 86%. The crude Guillain-Barré syndrome incidence rate was 0.69 per 100,000 person years and peaked at two years of age. The incidence rate was higher among men (0.80) than women (0.58) and was relatively stable over the 30-year period. No seasonal difference of the incidence rate was found. Of the 125 Guillain-Barré syndrome cases, 63% were preceded by infection, whereas none were preceded by surgery or malignant disease. Medically treated pain was documented in 70%, mainly confined to the lower extremities. Conclusions: Pediatric Guillain-Barré syndrome diagnoses in the Danish National Patient Registry have high validity, the incidence peaks at the age of two years, and is preceded by infection in two-thirds of children. Lower extremity pain is a common clinical presentation in the acute setting.

Original language	English
Journal	Pediatric Neurology
Volume	107
Pages (from-to)	57-63
Number of pages	7
ISSN	0887-8994
DOIs	https://doi.org/10.1016/j.pediatrneurol.2020.01.017
Publication status	Published - 2020

Keywords

GBS characteristics
GBS epidemiology
GBS incidence
GBS risk factors
GBS validation
Pediatric GBS

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10.1016/j.pediatrneurol.2020.01.017

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@article{355365366b7947de81680ed7294183a8,

title = "Pediatric Guillain-Barr{\'e} Syndrome in a 30-Year Nationwide Cohort",

abstract = "Background: Guillain-Barr{\'e} syndrome is the most common cause of acute flaccid paresis in childhood. Few validated large-scale population-based data are available concerning pediatric Guillain-Barr{\'e} syndrome, including incidence, risk factors, and initial clinical characteristics. Methods: In the Danish National Patient Registry, we identified all children aged below 16 years (N = 212) diagnosed with Guillain-Barr{\'e} syndrome and admitted to any Danish department of pediatrics between 1987 and 2016. A total of 145 (68%) medical files could be retrieved and reviewed, enabling classification of patients with true Guillain-Barr{\'e} syndrome. The nationwide Guillain-Barr{\'e} syndrome incidence rate was calculated and stratified by age, gender, time periods, and season. Risk factors and initial Guillain-Barr{\'e} syndrome characteristics were assessed by medical record review. Results: The positive predictive value of Guillain-Barr{\'e} syndrome diagnosis codes was 86%. The crude Guillain-Barr{\'e} syndrome incidence rate was 0.69 per 100,000 person years and peaked at two years of age. The incidence rate was higher among men (0.80) than women (0.58) and was relatively stable over the 30-year period. No seasonal difference of the incidence rate was found. Of the 125 Guillain-Barr{\'e} syndrome cases, 63% were preceded by infection, whereas none were preceded by surgery or malignant disease. Medically treated pain was documented in 70%, mainly confined to the lower extremities. Conclusions: Pediatric Guillain-Barr{\'e} syndrome diagnoses in the Danish National Patient Registry have high validity, the incidence peaks at the age of two years, and is preceded by infection in two-thirds of children. Lower extremity pain is a common clinical presentation in the acute setting.",

keywords = "GBS characteristics, GBS epidemiology, GBS incidence, GBS risk factors, GBS validation, Pediatric GBS",

author = "Levison, {Lotte Sahin} and Thomsen, {Reimar Wernich} and Markvardsen, {Lars Kj{\o}bsted} and Christensen, {Diana Hedevang} and Sindrup, {S{\o}ren Hein} and Henning Andersen",

year = "2020",

doi = "10.1016/j.pediatrneurol.2020.01.017",

language = "English",

volume = "107",

pages = "57--63",

journal = "Pediatric Neurology",

issn = "0887-8994",

publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Pediatric Guillain-Barré Syndrome in a 30-Year Nationwide Cohort

AU - Levison, Lotte Sahin

AU - Thomsen, Reimar Wernich

AU - Markvardsen, Lars Kjøbsted

AU - Christensen, Diana Hedevang

AU - Sindrup, Søren Hein

AU - Andersen, Henning

PY - 2020

Y1 - 2020

N2 - Background: Guillain-Barré syndrome is the most common cause of acute flaccid paresis in childhood. Few validated large-scale population-based data are available concerning pediatric Guillain-Barré syndrome, including incidence, risk factors, and initial clinical characteristics. Methods: In the Danish National Patient Registry, we identified all children aged below 16 years (N = 212) diagnosed with Guillain-Barré syndrome and admitted to any Danish department of pediatrics between 1987 and 2016. A total of 145 (68%) medical files could be retrieved and reviewed, enabling classification of patients with true Guillain-Barré syndrome. The nationwide Guillain-Barré syndrome incidence rate was calculated and stratified by age, gender, time periods, and season. Risk factors and initial Guillain-Barré syndrome characteristics were assessed by medical record review. Results: The positive predictive value of Guillain-Barré syndrome diagnosis codes was 86%. The crude Guillain-Barré syndrome incidence rate was 0.69 per 100,000 person years and peaked at two years of age. The incidence rate was higher among men (0.80) than women (0.58) and was relatively stable over the 30-year period. No seasonal difference of the incidence rate was found. Of the 125 Guillain-Barré syndrome cases, 63% were preceded by infection, whereas none were preceded by surgery or malignant disease. Medically treated pain was documented in 70%, mainly confined to the lower extremities. Conclusions: Pediatric Guillain-Barré syndrome diagnoses in the Danish National Patient Registry have high validity, the incidence peaks at the age of two years, and is preceded by infection in two-thirds of children. Lower extremity pain is a common clinical presentation in the acute setting.

AB - Background: Guillain-Barré syndrome is the most common cause of acute flaccid paresis in childhood. Few validated large-scale population-based data are available concerning pediatric Guillain-Barré syndrome, including incidence, risk factors, and initial clinical characteristics. Methods: In the Danish National Patient Registry, we identified all children aged below 16 years (N = 212) diagnosed with Guillain-Barré syndrome and admitted to any Danish department of pediatrics between 1987 and 2016. A total of 145 (68%) medical files could be retrieved and reviewed, enabling classification of patients with true Guillain-Barré syndrome. The nationwide Guillain-Barré syndrome incidence rate was calculated and stratified by age, gender, time periods, and season. Risk factors and initial Guillain-Barré syndrome characteristics were assessed by medical record review. Results: The positive predictive value of Guillain-Barré syndrome diagnosis codes was 86%. The crude Guillain-Barré syndrome incidence rate was 0.69 per 100,000 person years and peaked at two years of age. The incidence rate was higher among men (0.80) than women (0.58) and was relatively stable over the 30-year period. No seasonal difference of the incidence rate was found. Of the 125 Guillain-Barré syndrome cases, 63% were preceded by infection, whereas none were preceded by surgery or malignant disease. Medically treated pain was documented in 70%, mainly confined to the lower extremities. Conclusions: Pediatric Guillain-Barré syndrome diagnoses in the Danish National Patient Registry have high validity, the incidence peaks at the age of two years, and is preceded by infection in two-thirds of children. Lower extremity pain is a common clinical presentation in the acute setting.

KW - GBS characteristics

KW - GBS epidemiology

KW - GBS incidence

KW - GBS risk factors

KW - GBS validation

KW - Pediatric GBS

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U2 - 10.1016/j.pediatrneurol.2020.01.017

DO - 10.1016/j.pediatrneurol.2020.01.017

M3 - Journal article

C2 - 32192820

AN - SCOPUS:85081745755

SN - 0887-8994

VL - 107

SP - 57

EP - 63

JO - Pediatric Neurology

JF - Pediatric Neurology

ER -

Pediatric Guillain-Barré Syndrome in a 30-Year Nationwide Cohort

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