Guillain‐Barré syndrome (GBS) is the most common cause of acute flaccid paralysis in children. The objective of this study was to investigate the preceding infections, clinical, serological and electrophysiological characteristics and outcome of childhood GBS in Bangladesh. We included 174 patients with GBS aged <18 years from a prospective cohort in Bangladesh between 2010 and 2018. We performed multivariate logistic regression to determine the risk factors for poor outcome. Among 174 children with GBS, 74% (n = 129) were male. Around half of the patients (49%, n = 86) had severe muscle weakness, 65% (n = 113) were bedbound (GBS disability score 4) and 17% (n = 29) patients required mechanical ventilation at admission. Campylobacter jejuni serology and anti‐GM1 IgG antibody were positive in 66% and 21% of the patients respectively. One hundred and forty‐three (82%) patients did not receive standard treatment and half of them recovered fully or with minor deficits at 6‐month. Twenty patients (11%) died throughout the study period. At 3‐month of onset of weakness, complete recovery or recovery with minor deficit was significantly higher in demyelinating GBS patients compared to axonal GBS patients (86% vs 51%, P = .001). Cranial nerve palsy (OR = 4.00, 95%CI = 1.55‐10.30, P = .004) and severe muscle weakness (OR = 0.16, 95%CI = 0.06‐0.45, P = .001) were the important risk factors of poor outcome in children with GBS. Further large‐scale studies are required for better understanding of factors associated with mortality and morbidity in childhood GBS.

中文翻译：

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儿童吉兰-巴雷综合征的临床和血清学预后因素：孟加拉国的一项前瞻性队列研究

格林-巴利综合征 (GBS) 是儿童急性弛缓性麻痹的最常见原因。本研究的目的是调查孟加拉国儿童 GBS 的先前感染、临床、血清学和电生理特征以及结果。我们从 2010 年至 2018 年间在孟加拉国的一个前瞻性队列中纳入了 174 名年龄 <18 岁的 GBS 患者。我们进行了多变量逻辑回归以确定不良结局的风险因素。在 174 名 GBS 儿童中，74% (n = 129) 是男性。大约一半的患者 (49%, n = 86) 有严重的肌肉无力，65% (n = 113) 卧床不起（GBS 残疾评分 4），17% (n = 29) 的患者在入院时需要机械通气。空肠弯曲杆菌血清学和抗 GM1 IgG 抗体分别在 66% 和 21% 的患者中呈阳性。143 (82%) 名患者未接受标准治疗，其中一半在 6 个月时完全康复或有轻微缺陷。在整个研究期间，20 名患者 (11%) 死亡。在出现虚弱 3 个月时，脱髓鞘 GBS 患者的完全康复或轻度缺陷恢复明显高于轴突 GBS 患者（86% 对 51%，P = .001）。颅神经麻痹（OR = 4.00，95%CI = 1.55-10.30，P = .004）和严重肌肉无力（OR = 0.16，95%CI = 0.06-0.45，P= .001) 是 GBS 儿童预后不良的重要危险因素。需要进一步的大规模研究以更好地了解与儿童 GBS 死亡率和发病率相关的因素。