العطيفة الصائميةcampylobacter jejuni

أفضل علاج لها هو erythromycin
أشيع عامل مسبب للinvasive diarrhea in USA

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UTD

MECHANISMS — The proposed mechanism for Guillain-Barré syndrome (GBS) is that an antecedent infection evokes an immune response, which in turn cross-reacts with peripheral nerve components because of the sharing of cross-reactive epitopes (molecular mimicry) [2]. The end result is an acute polyneuropathy. This immune response can be directed towards the myelin or the axon of peripheral nerve.

Immune reactions directed against epitopes in Schwann cell surface membrane or myelin can cause acute inflammatory demyelinating neuropathy (AIDP) [2]. The pathology is that of multifocal inflammatory demyelination starting at the level of the nerve roots. The earliest changes are frequently seen at the nodes of Ranvier. Both the cellular and humoral immune responses participate in the process. Invasion by activated T-cells is followed by macrophage-mediated demyelination with evidence of complement and immunoglobulin deposition on myelin and Schwann cells [3-5]. No specific myelin antigen(s) have been identified.

Immune reactions against epitopes contained in the axonal membrane cause the acute axonal forms of GBS: acute motor axonal neuropathy (AMAN) and acute motor and sensory axonal neuropathy (AMSAN) [2]. These forms are uncommon in the United States, but the pathophysiology of these variants is better understood than that of AIDP.

SUMMARY — The Guillain-Barré syndrome (GBS) is an acute monophasic illness causing a rapidly progressive polyneuropathy with weakness or paralysis. Guillain-Barré syndrome is thought to result from an immune response to a preceding infection that cross-reacts with peripheral nerve components because of molecular mimicry. The immune response can be directed towards the myelin or the axon of peripheral nerve, resulting in demyelinating and axonal forms of GBS. (See "Mechanisms" above and see "Molecular mimicry" above). Campylobacter jejuni infection is the most commonly identified precipitant of GBS. Cytomegalovirus, Epstein-Barr virus, and human immunodeficiency virus (HIV) infection have also been associated with GBS.

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