All issues > Volume 42(8); 1999

Case Report

J Korean Pediatr Soc. 1999;42(8):1165-1169. Published online August 15, 1999.

A Case of Guillain-Barré Syndrome Coinciding with Bronchial Asthma associated with Mycoplasma Pneumonia

Kyung-Yil KY Lee¹, Dong-Joon DJ Lee¹, Ji-Whan JW Han¹, Sang-Won SW Ch¹, John-Sung JS Lee¹, Kyung-Tai KT Whang¹

¹Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence Kyung-Yil KY Lee ,Email: 1

Abstract

Mycoplasma pneumoniae is the most common etiologic agent of pneumonia in school-aged children and young adults. It involves not only the respiratory system but includes extrapulmonary complications such as exanthem, hemolysis, arthritis, hepatic dysfuction, cardiac disease, and central nervous system disease. The pathogenesis of extrapulmonary involvements may be an autoimmune phenomena. Recent studies suggest that bronchial asthma can be initiated by Mycoplasma pneumoniae infection. We experienced a five-year-old girl suffering simultaneously from Guillain- Barré syndrome and initial bronchial asthmatic attack after mycoplasma pneumonia. She was admitted with lower-leg pain and weakness for three days. Ten days before admission, she was coughing and showed on a chest X-ray, pneumonic infitrations of both subhilar peribronchial areas. The titers of anti-mycoplasma antibody and cold hemagglutinin were 1:80 and 1:32, respectively. With a progression of paralysis to the upper extremities, she showed dyspnea, dysphagia and right facial palsy on the second hospital day. We performed a tracheostomy and started artificial ventilation. Unexpectedly, she showed continuous dyspnea, poor lung aeration and revealed severe hypoxemia in serial arterial gas analysis. Intravenous theophylline, high-dose corticosteroid and intravenous immunoglobulin therapy resulted in a progressive improvement of lung condition. She recovered completely from neurologic and pulmonic complications after five weeks.

Keywords :Mycoplasma pneumonia, Guillain-Barré syndrome, Bronchial asthma