Guillain-Barré syndrome in a child with ongoing Hepatitis A viral infection

Guillain-Barré syndrome (GBS) belongs to the group of peripheral immune-mediated neuropathies and is often preceded by an inflammatory episode. GBS is rarely associated with hepatitis A viral (HAV) infection, the latter as a rule antecedent of the neurological disorders. This association is quite rare in childhood, and only isolated cases have been described. We report an unusual case of pediatric GBS which development coincided with the development of HAV IgM () acute hepatitis A. From the 2nd to the 14th day after admission to hospital for mild jaundice of the skin and sclera in 12-year-old boy, the following neurological disorders have developed: absent Achilles and knee jerk reflexes, diminished brachioradialis reflex, moderately decreased muscle power in the upper extremities, and more pronounced power loss in the lower extremities. Facial palsy developed bilaterally, more expressed to the right. There was albuminocytologic dissociation of the cerebrospinal fluid and stimulation electromyography (EMG) showed findings compatible with the GBS subdivision - Acute inflammatory demyelinating polyneuropathy (AIDP). Our case report has shown that hepatitis A virus can trigger GBS in the very beginning of HAV infection in children, and this may be due to some common pathogenic mechanisms shared by both diseases.