Reader Response: An International Perspective on Preceding Infections in Guillain-Barré Syndrome: The IGOS-1000 Cohort
Abstract
Leonhard et al. analyzed the pattern of preceding infections in a large cohort of 768 patients with Guillain-Barré syndrome (GBS) from 19 countries spread over 5 continents.1 To some extent, this study is biased because the majority of the patients were from temperate regions and testing for preceding infections was limited to only 5 microorganisms (Campylobacter jejuni, hepatitis E virus, Mycoplasma pneumoniae, cytomegalovirus, and Epstein-Barr virus). The burden of infections varies significantly across tropical and temperate regions, with arboviral infections being quite prevalent in the tropics. Dengue, chikungunya, Japanese encephalitis, and zika have consistently been associated with GBS.2-4
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 768 participants or records.
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