Campylobacter-associated Guillain-Barre syndrome after orthotopic liver transplantation for hepatitis C cirrhosis: a case report

Guillain-Barre syndrome is characterized by acute paralysis and ascending neuropathy due to an inflammatory attack on the myelin of peripheral nerves. About 2/3 of patients with Guillain-Barre syndrome have an infection 1-3 weeks before the onset of the symptoms. Guillain-Barre syndrome has rarely been reported after solid organ transplantation (18 cases with three cases after liver transplantation), and these cases are mostly related to a CMV infection. We describe a 64-year-old male patient who developed Guillain-Barre syndrome related to a Campylobacter fetus enteritis, 70 days post liver transplantation. Although the patient received tacrolimus as immunosuppressant agent and is hepatitis C positive, we can conclude that the Campylobacter infection was probably the primary trigger for the development of Guillain-Barre syndrome. As T-cell response is depressed in our patient and cross-reactive antibodies (anti-ganglioside GM-1) exists after Campylobacter infection, we suppose that a humorally mediated attack is responsible for Guillain-Barre syndrome after solid organ transplantation. A review of the literature is performed. (C) 2002 Elsevier Science B.V. All rights reserved.