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  1. Article ; Online: Patient With Rigidity and Fasciculations: Steroid-Responsive Presentation of Anti-IgLON5 Disease

    Bellucci, Margherita / Castellano, Chiara / Marinelli, Lucio / Garbarino, Lucia / Gastaldi, Matteo / Franciotta, Diego / Benedetti, Luana

    Neurology

    2024  Volume 102, Issue 3, Page(s) e208110

    Abstract: An 82-year-old man presented with 2-year lasting widespread muscular fasciculations, cramps, and limb stiffness, with spontaneous movements in the right lower limb, unsteady gait (Video 1), and falls. Neurophysiologic studies disclosed signs of ... ...

    Abstract An 82-year-old man presented with 2-year lasting widespread muscular fasciculations, cramps, and limb stiffness, with spontaneous movements in the right lower limb, unsteady gait (Video 1), and falls. Neurophysiologic studies disclosed signs of neuromuscular hyperexcitability. CSF analysis showed high tau protein concentration (543 pg/mL; reference values, <404) and unique-to-CSF oligoclonal bands. Serum and CSF anti-IgLON5 antibodies were positive (Figure 1). He carried the anti-IgLON5 disease-associated HLA-DRB1*10:01 allele.
    MeSH term(s) Aged, 80 and over ; Humans ; Male ; Encephalitis/drug therapy ; Fasciculation ; Hashimoto Disease ; Methylprednisolone/therapeutic use ; Parasomnias ; Sleep Apnea, Obstructive
    Chemical Substances Methylprednisolone (X4W7ZR7023)
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Case Reports ; Journal Article ; Video-Audio Media
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000208110
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Response to the letter of Gemignani et al.

    Grisanti, Stefano Giuseppe / Bellucci, Margherita / Germano, Francesco / Schenone, Cristina / Barisione, Emanuela / Garbarino, Sara / Piana, Michele / Pardini, Matteo / Benedetti, Luana

    Journal of the neurological sciences

    2022  Volume 444, Page(s) 120491

    Language English
    Publishing date 2022-11-24
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2022.120491
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: COVID-19-associated serum and cerebrospinal fluid cytokines in post- versus para-infectious SARS-CoV-2-related Guillain-Barré syndrome.

    Massa, Federico / Vigo, Tiziana / Bellucci, Margherita / Giunti, Debora / Emanuela, Maria Mobilia / Visigalli, Davide / Capodivento, Giovanna / Cerne, Denise / Assini, Andrea / Boni, Silvia / Rizzi, Domenica / Narciso, Eleonora / Grisanti, Giuseppe Stefano / Coco, Elena / Uccelli, Antonio / Schenone, Angelo / Franciotta, Diego / Benedetti, Luana

    Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

    2024  Volume 45, Issue 3, Page(s) 849–859

    Abstract: Introduction: Guillain-Barré syndrome associated with Coronavirus-2-related severe acute respiratory syndrome (COV-GBS) occurs as para- or post-infectious forms, depending on the timing of disease onset. In these two forms, we aimed to compare the ... ...

    Abstract Introduction: Guillain-Barré syndrome associated with Coronavirus-2-related severe acute respiratory syndrome (COV-GBS) occurs as para- or post-infectious forms, depending on the timing of disease onset. In these two forms, we aimed to compare the cerebrospinal fluid (CSF) and serum proinflammatory cytokine profiles to evaluate differences that could possibly have co-pathogenic relevance.
    Materials and methods: We studied a retrospective cohort of 26 patients with either post-COV-GBS (n = 15), with disease onset occurring > 7 days after SARS-CoV-2 infection, or para-COV-GBS (n = 11), with disease onset 7 days or less. TNF-α, IL-6, and IL-8 were measured in the serum with SimplePlex™ Ella™ immunoassay. In addition to the para-/post-COV-GBS patients, serum levels of these cytokines were determined in those with non-COVID-associated-GBS (NC-GBS; n = 43), paucisymptomatic SARS-CoV-2 infection without GBS (COVID, n = 20), and in healthy volunteers (HV; n = 12). CSF cytokine levels were measured in patients with para-/post-COV-GBS, in those with NC-GBS (n = 29), or with Alzheimer's disease (AD; n = 24).
    Results: Serum/CSF cytokine levels did not differ in para- vs post-COV-GBS. We found that SARS-CoV-2 infection raises the serum levels of TNF-α, IL-6, and IL-8, as well as an increase of IL-6 (in serum and CSF) and IL-8 (in CSF) in either NC-GBS or COV-GBS than controls. CSF and serum cytokine levels resulted independent one with another.
    Conclusions: The change of cytokines linked to SARS-CoV-2 in COV-GBS appears to be driven by viral infection, although it has unique characteristics in GBS as such and does not account for cases with para- or post-infectious onset.
    MeSH term(s) Humans ; COVID-19/complications ; SARS-CoV-2 ; Guillain-Barre Syndrome/complications ; Cytokines ; Interleukin-6/cerebrospinal fluid ; Tumor Necrosis Factor-alpha ; Retrospective Studies ; Interleukin-8
    Chemical Substances Cytokines ; Interleukin-6 ; Tumor Necrosis Factor-alpha ; Interleukin-8
    Language English
    Publishing date 2024-01-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2016546-8
    ISSN 1590-3478 ; 1590-1874
    ISSN (online) 1590-3478
    ISSN 1590-1874
    DOI 10.1007/s10072-023-07279-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Case Report: Post-COVID-19 Vaccine Recurrence of Guillain-Barré Syndrome Following an Antecedent Parainfectious COVID-19-Related GBS.

    Bellucci, Margherita / Germano, Francesco / Grisanti, Stefano / Castellano, Chiara / Tazza, Francesco / Mobilia, Emanuela Maria / Visigalli, Davide / Novi, Giovanni / Massa, Federico / Rossi, Silvia / Durando, Paolo / Cabona, Corrado / Schenone, Angelo / Franciotta, Diego / Benedetti, Luana

    Frontiers in immunology

    2022  Volume 13, Page(s) 894872

    Abstract: Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder often preceded by viral illnesses or, more rarely, vaccinations. We report on a unique combination of postcoronavirus disease 2019 (COVID-19) vaccine GBS that occurred months after a ... ...

    Abstract Guillain-Barré syndrome (GBS) is an autoimmune neurological disorder often preceded by viral illnesses or, more rarely, vaccinations. We report on a unique combination of postcoronavirus disease 2019 (COVID-19) vaccine GBS that occurred months after a parainfectious COVID-19-related GBS. Shortly after manifesting COVID-19 symptoms, a 57-year-old man developed diplopia, right-side facial weakness, and gait instability that, together with electrophysiology and cerebrospinal fluid examinations, led to a diagnosis of post-COVID-19 GBS. The involvement of cranial nerves and IgM seropositivity for ganglioside GD1b were noteworthy. COVID-19 pneumonia, flaccid tetraparesis, and autonomic dysfunction prompted his admission to ICU. He recovered after therapy with intravenous immunoglobulins (IVIg). Six months later, GBS recurred shortly after the first dose of the Pfizer/BioNTech vaccine. Again, the GBS diagnosis was confirmed by cerebrospinal fluid and electrophysiology studies. IgM seropositivity extended to multiple gangliosides, namely for GM3/4, GD1a/b, and GT1b IgM. An IVIg course prompted complete recovery. This case adds to other previously reported observations suggesting a possible causal link between SARS-CoV-2 and GBS. Molecular mimicry and anti-idiotype antibodies might be the underlying mechanisms. Future COVID-19 vaccinations/revaccinations in patients with previous para-/post-COVID-19 GBS deserve a reappraisal, especially if they are seropositive for ganglioside antibodies.
    MeSH term(s) Autoantibodies ; COVID-19/complications ; COVID-19 Vaccines/adverse effects ; Gangliosides ; Guillain-Barre Syndrome/diagnosis ; Guillain-Barre Syndrome/etiology ; Humans ; Immunoglobulin M/therapeutic use ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Middle Aged ; SARS-CoV-2
    Chemical Substances Autoantibodies ; COVID-19 Vaccines ; Gangliosides ; Immunoglobulin M ; Immunoglobulins, Intravenous
    Language English
    Publishing date 2022-07-18
    Publishing country Switzerland
    Document type Case Reports ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2022.894872
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: COVID-19 vaccine-related Guillain-Barré syndrome in the Liguria region of Italy: A multicenter case series.

    Germano, Francesco / Bellucci, Margherita / Grisanti, Stefano / Beronio, Alessandro / Grazzini, Matteo / Coco, Elena / Tassinari, Tiziana / Della Cava, Fabio / De Michelis, Chiara / Baldi, Ottavia / Sivori, Giorgia / Murialdo, Alessandra / Cabona, Corrado / Durando, Paolo / Uccelli, Antonio / Schenone, Angelo / Franciotta, Diego / Benedetti, Luana

    Journal of the neurological sciences

    2022  Volume 440, Page(s) 120330

    Abstract: Background and purpose: Guillain-Barré-Syndrome (GBS) can follow COVID-19 vaccination, with clinical and paraclinical features still to be precisely assessed. We describe a cohort of patients who developed GBS after vaccination with different types of ... ...

    Abstract Background and purpose: Guillain-Barré-Syndrome (GBS) can follow COVID-19 vaccination, with clinical and paraclinical features still to be precisely assessed. We describe a cohort of patients who developed GBS after vaccination with different types of COVID-19 vaccines.
    Methods: Patients with post-COVID-19 vaccination GBS, admitted to the six hospitals that cover the whole Liguria Region, Northwestern Italy, from February 1st to October 30th 2021, were included. Clinical, demographic, and paraclinical data were retrospectively collected.
    Results: Among the 13 patients with post-COVID-19 vaccination GBS (9 males; mean age, 64 year), 5 were vaccinated with Oxford-AstraZeneca, 7 with Pfizer-BioNTech, and one with Moderna. Mean time between vaccination and GBS onset was 11.5 days. Ten patients developed GBS after the first vaccination dose, 3 after the second dose. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the predominant GBS variant, mainly characterized by sensory involvement. Bilateral seventh cranial nerve involvement followed AstraZeneca vaccination in two cases. Three patients presented treatment-related fluctuations, and 4 mild symptoms that delayed treatments and negatively affected prognosis. Prognosis was poor (GBS-disability score, ≥3) in 5/13 patients, with a disability rate of 3/13.
    Conclusions: Our findings confirm that most post-COVID-19 vaccination GBS belong to the AIDP subtype, and occur after the first vaccine dose. Treatment-related fluctuations, and diagnosis-delaying, mild symptoms at onset are clinical features that affect prognosis and deserve particular consideration.
    MeSH term(s) COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Guillain-Barre Syndrome/diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vaccination
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-06-25
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80160-4
    ISSN 1878-5883 ; 0022-510X ; 0374-8642
    ISSN (online) 1878-5883
    ISSN 0022-510X ; 0374-8642
    DOI 10.1016/j.jns.2022.120330
    Database MEDical Literature Analysis and Retrieval System OnLINE

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