Short communicationTakotsubo cardiomyopathy associated with Guillain–Barré syndrome: A differential diagnosis from dysautonomia not to be missed
Introduction
The Guillain–Barré syndrome (GBS) is an autoimmune disease affecting the peripheral nervous system, which may present with autonomic dysfunction, including electrocardiographic changes. In this report, we describe the case of a patient suffering from a GBS who had asymptomatic electrocardiographic abnormalities not related to dysautonomia but to a transient left ventricular apical ballooning cardiomyopathy, also called “Takotsubo syndrome”, who needs adequate management and specific therapeutic strategies. This diagnosis should not be missed. Therefore, a trans-thoracic echocardiography should be performed when repolarisation abnormalities are present in GBS, even in asymptomatic patients, as this easy paraclinic tool can diagnose an unexpected cardiomyopathy.
Section snippets
Case presentation
A 60-year-old woman presented with a 1-week progressive limb weakness and an areflexic tetraparesis. Her only cardiovascular risk factor was hypertension.
Nerve conduction study disclosed reduced motor conduction velocity in all limbs, particularly in the lower limbs. The sensory conduction was normal in the lower limbs. Needle electromyogram showed a slight reduction in the pattern of recruitment during effort in all muscles examined, and fibrillation potentials were absent. Cerebrospinal fluid
Discussion
The GBS is an autoimmune disease affecting the peripheral nervous system, which may present with autonomic dysfunction (hypotension, hypertension, sinus tachycardia, and electrocardiographic changes) [1], [2], [3]. There have been few case reports associating GBS and electrocardiographic abnormalities or left ventricular dysfunction [2], [4], [5]. Usually explained by temporary alterations in cardiac innervations or catecholamine cardiotoxicity, ECG abnormalities are often regressive. We
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