Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of Guillain-Barré syndrome with elevated IgG anticardiolipin antibody titer with recurrent deep venous thromboses

Yasushi Miyoshi, M.D.1), Yasunobu Abe, M.D.2), Shin-ichiro Kobori, M.D.3), Sadatoshi Tsuji, M.D.3) and Seido Miyoshi, M.D.1)

1)Department of Neurology, Asagi Hospital, 2)Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University,
3)Department of Neurology, University of Occupational and Environmental Health

We report a 76-year-old woman with Guillain-Barré syndrome (GBS) who developed recurrent deep venous thromboses (DVT). She has had no past medical history of thromboembolic events or fetal loss. Because D-dimer was elevated from the early stage of her illness, heparin, and then warfarin, was given as prophylaxis for thromboembolic events. On Day 103, she developed marked edema in her legs, and DVT was diagnosed in the left popliteal vein by ultrasound. Three days later, the patient developed pulmonary embolism, and an inferior vena cava filter was implanted. Although D-dimer became temporarily normal, it increased again, and recurrent DVT was diagnosed in bilateral femoral veins on Day 167. IgG anticardiolipin antibody titer was found to be highly elevated at 79 U/ml (normal range: <10). However, anti-beta 2 glycoprotein I antibody, which has been proven to be associated with antiphospholipid syndrome (APS), was negative. Thus, IgG anticardiolipin may have played an important role in the thromboembolic events in this patient. We speculate that the occurrence of APS may be associated with anticardiolipin antibody, which may form in some patients with GBS secondary to myelin damage.

(CLINICA NEUROL, 46: 572－574, 2006)
key words: Guillain-Barré syndrome, anticardiolipin antibodies, deep vein thorombosis, pulmonary embolism, D-dimer

(Received: 20-Feb-06)