Ref Number = PITIKA-ASPR0011
Faisal Ambar, Hadia Angriani, Urfianty
Background. Guillain–Barre syndrome (GBS) is an immune polyradiculoneuropathy presents with ascending bilateral lower extremity weakness and areflexia that affects all age groups with incidence female more than male. GBS can also probably be an outcome of viral or bacterial infection. The viral and bacteria are likely change the nature of the nervous system in such a way that the immune system cannot recognize the cells as its own and can allow some immune cells (lymphocytes and macrophages) to attack myelin and leading to destruction of the myelin sheath.
Case.A three-year-and-one-month-old boy admitted to Dr. Wahidin Sudirohusodo Hospital with general weakness in lower limbs since 13 days before admission and ascended rapidly. One month prior to presentation, he had flu-like symptoms. On physical examination: decreased in muscle strength and hyporeflxia in both lower and upper limbs with no deep tendon reflexes, neither Babinsky reflex. Breathing and swallow function did not deteriorate and required no further intervention.The laboratory results: Hb 13,5 gr/dL, WBC 10.800/mm3, PLT 366.000/mm3 , cerebral fluid analysis showed protein 200 mg/dl. Nerve conduction (electromyelography) revealed Acute Motor Sensory Axonal Neuropathy. The patient was treated with a 5-day course of intravenous immunoglobulins. He improved significantly after the next 9th day and patient are permitted to discharge. 
Conclusion.A case of Guillain–Barre syndrome (GBS) in a 3-year-old boy has been reported. The diagnosis was based on history taking, physical examination, laboratory finding, cerebrospinal fluid and nerve conduction (electromyelography). The choice of therapy was intravenous immunoglobulins and prognosis of this patient was dubia.
Keywords: Guillain-barre syndrome, Immunoglobulin, acute motor sensor axonal neuropathy
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