J Korean Pediatr Soc.  1999 Aug;42(8):1165-1169.

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

• Lee KY
• Lee DJ
• Cha SW
• Han JW
• Lee JS
• Whang KT

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-Barr 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.

Keyword

Mycoplasma pneumonia; Guillain-Barr syndrome; Bronchial asthma

MeSH Terms

Anoxia
Arthritis
Asthma*
Central Nervous System
Child
Cough
Deglutition Disorders
Dyspnea
Exanthema
Facial Paralysis
Female
Heart Diseases
Hemagglutinins
Hemolysis
Humans
Immunization, Passive
Lung
Mycoplasma pneumoniae
Mycoplasma*
Paralysis
Pneumonia
Pneumonia, Mycoplasma*
Respiratory System
Theophylline
Thorax
Tracheostomy
Upper Extremity
Ventilation
Young Adult
Hemagglutinins
Theophylline