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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">PAR</journal-id><journal-title-group><journal-title>Proceedings of Anticancer Research</journal-title></journal-title-group><issn>2208-3545</issn><eissn>2208-3553</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/par.v8i3.7229</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>A Case Report of Recurrent Guillain-Barré Syndrome with Orthostatic Hypotension Syncope as the First Symptom</title><url>https://artdesignp.com/journal/PAR/8/3/10.26689/par.v8i3.7229</url><author>YanShuai,LiuXin,WangLuxuan</author><pub-date pub-type="publication-year"><year>2024</year></pub-date><volume>8</volume><issue>3</issue><history><date date-type="pub"><published-time>2024-06-19</published-time></date></history><abstract>Guillain⁃Barré syndrome (GBS) is an immune-mediated peripheral neuropathy with acute or subacute onset of flaccid paralysis of the limbs with symmetrical hypesthesia and autonomic nerve involvement [1]. The clinical manifestations of autonomic nerve damage are complex and varied, which may involve extensive or limited autonomic function damage, including abnormalities of the skin, pupil, urinary tract, gastrointestinal tract, cardiovascular system, body temperature, lacrimal and salivary glands, and sexual function, etc. [2], and some patients may even have autonomic nerve damage as the only symptom, which is a variant of GBS and is prone to misdiagnosis or underdiagnosis. Recurrence of GBS is rare, and the manifestations of recurrence are often similar to those of the first symptoms [3], but the patient admitted to our hospital had syncope as the main clinical manifestation of recurrence, which was completely different from that of the first incidence, and syncope is not a common and typical clinical manifestation of GBS, so misdiagnosis is highly likely.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Shahrizaila N, Lehmann HC, Kuwabara S, 2021, Guillain-Barré Syndrome. Lancet, 397(10280): 1214–1228.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>Hart RG, Kanter MC, 1990, Acute Autonomic Neuropathy. Arch Intern Med, (150): 2374–2376.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B3" content-type="article"><label>3</label><element-citation publication-type="journal"><p>Kuitwaard K, Van Koningsveld R, Ruts L, et al., 2009, Recurrent Guillain-Barre Syndrome. J Neurol Neurosurg Psychiatry, 80(1): 56–59.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B4" content-type="article"><label>4</label><element-citation publication-type="journal"><p>Pfeiffer G, 1999, Dysautonomia in Guillain Barr Syndrome. Nervenarzt, 70(2): 136–148.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B5" content-type="article"><label>5</label><element-citation publication-type="journal"><p>Liehtenfeld P, 1971, Autonomic Dysfunction in the Guillian-Barre Syndrome. Am J med, 50(4): 772.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B6" content-type="article"><label>6</label><element-citation publication-type="journal"><p>Anandan C, Khuder SA, Koffman BM, 2017, Prevalence of Autonomic Dysfunction in Hospitalised Patients with Guillain-Barré Syndrome. Muscle Nerve, 56(2): 331–333.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B7" content-type="article"><label>7</label><element-citation publication-type="journal"><p>Gupta S, Verma R, Sethi R, et al., 2020, Cardiovascular Complications and Its Relationship with Functional Outcomes in Guillain-Barré Syndrome. QJM, 113(2): 93–99.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B8" content-type="article"><label>8</label><element-citation publication-type="journal"><p>James N, Reddy S, Maheshwari U, et al., 2024, Incidence of Cardiovascular Instability in Patients with Guillain-Barré Syndrome: A Retrospective Study. Cureus, 16(1): e52778.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B9" content-type="article"><label>9</label><element-citation publication-type="journal"><p>van den Berg B, Bunschoten C, van Doorn PA, et al., 2013, Mortality in Guillain-Barre Syndrome. Neurology, 80(18): 1650–1654.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B10" content-type="article"><label>10</label><element-citation publication-type="journal"><p>Zhang Q, Gu Z, Jiang J, et al., 2010, Orthostatic Hypotension as a Presenting Symptom of the Guillain-Barré Syndrome. Clin Auton Res, (20): 209–210.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B11" content-type="article"><label>11</label><element-citation publication-type="journal"><p>Tan CY, Shahrizaila N, Tan HT, et al., 2022, Cardiovascular Autonomic Assessment in Guillain-Barré Syndrome: A Longitudinal Study. Neurol India, 70(5): 1856–1859.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B12" content-type="article"><label>12</label><element-citation publication-type="journal"><p>Sakakibara R, Uchiyama T, Tamura N, et al., 2006, Urinary Retention and Sympathetic Sphincter Obstruction in Axonal Guillain-Barré Syndrome. Muscle Nerve, 35(1): 111–115.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B13" content-type="article"><label>13</label><element-citation publication-type="journal"><p>Das A, Kalita J, Misra UK, 2004, Recurrent Guillain Barre Syndrome. Electromyogr Clin Neurophysiol, 44(2): 95–102.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B14" content-type="article"><label>14</label><element-citation publication-type="journal"><p>Mossberg N, Nordin M, Movitz C, et al., 2012, The Recurrent Guillain-Barre Syndrome: A Long-Term Population-Based Study. Acta Neurol Scand, 126(3): 154–161.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B15" content-type="article"><label>15</label><element-citation publication-type="journal"><p>Grand Maison F, Feasby TE, Hahn AF, et al., 1992, Recurrent Guillain-Barré Syndrome: Clinical and Laboratory Features. Brain, (115): 1093–1106.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B16" content-type="article"><label>16</label><element-citation publication-type="journal"><p>Basta I, Bozovic I, Berisavac I, et al., 2019, Recurrent Guillain-Barré Syndrome - Case Series. Neurol India, 67(6): 1536–1538.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B17" content-type="article"><label>17</label><element-citation publication-type="journal"><p>Ishii J, Yuki N, Kawamoto M, et al., 2016, Recurrent Guillain-Barré Syndrome, Miller Fisher Syndrome and Bickerstaff Brainstem Encephalitis. J Neurol Sci, 364: 59–64.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B18" content-type="article"><label>18</label><element-citation publication-type="journal"><p>Notturno F, Kokubun N, Sekiguki Y, et al., 2016, Demyelinating Guillain-Barré Syndrome Recurs More Frequently than Axonal Subtypes. J Neurol Sci, (365): 132–136.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B19" content-type="article"><label>19</label><element-citation publication-type="journal"><p>Luan H, Zhang P, Zhen M, et al., 2022, Recurrent Guillain-Barré Syndrome Presenting as Pharyngeal-Cervical-Brachial Variant with Three Species of Ganglioside Antibodies: Case Report. BMC Neurol, 22(1): 441.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B20" content-type="article"><label>20</label><element-citation publication-type="journal"><p>Wang S, Luo Z, Peng T, 2022, Serum Thyroid-Stimulating Hormone is an Independent Risk Factor of Recurrent Guillain-Barré Syndrome. Muscle Nerve, 65(6): 688–692.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B21" content-type="article"><label>21</label><element-citation publication-type="journal"><p>Wakerley BR, Yuki N, 2015, Guillain-Barre Syndrome. Expert Rev Neurother, 15(8): 847–849.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B22" content-type="article"><label>22</label><element-citation publication-type="journal"><p>Corston RN, McGale EH, Stonier C, et al., 1981, Abnormalities of Cerebrospinal Fluid Amino Acids in Patients with the Guillain-Barre Syndrome. J Neurol Neurosurg Psychiatry, 44(1): 86–89.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B23" content-type="article"><label>23</label><element-citation publication-type="journal"><p>Irani DN, 2009, Cerebrospinal Fluid in Clinical Practice, Saunders, Philadelphia, 121–125.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B24" content-type="article"><label>24</label><element-citation publication-type="journal"><p>Mateen FJ, Cornblath DR, Jafari H, et al., 2011, Guillain-Barre Syndrome in India: Population-Based Validation of the Brighton Criteria. Vaccine, (29): 9697–9701.</p><pub-id pub-id-type="doi"/></element-citation></ref></ref-list></back></article>
