ギラン・バレー症候群

Guillain-Barré syndrome

ギラン・バレー症候群は感染をはじめとする免疫学的刺激を契機に発症する急性免疫介在性ニューロパチーであり，補体介在性神経障害が主な病態である。約60％に糖脂質抗体を認める。近年では細胞性免疫の関与も示唆されている。経静脈的免疫グロブリン療法と血漿交換療法が確立された免疫治療である。本論では病態，診断，治療，予後と予後予測に関して，最新の知見を基に解説する。

Abstract

Guillain-Barré syndrome (GBS), an acute immune-mediated neuropathy, occurs following immunological stimulation, such as infection, with complement-mediated neuropathy implicated in the pathophysiology of this condition. Glycolipid antibodies produced by molecular mimicry are detected in approximately 60% of cases. Recent studies have suggested the role of cell-mediated immunity in the pathogenesis of GBS. Intravenous immunoglobulin and plasma exchange are established immunotherapies. In this article, based on the latest knowledge, we describe the pathophysiology, diagnosis, treatment, prognosis, and prognostic prediction of GBS. Furthermore, we discuss some GBS guidelines published by the European Academy of Neurology/Peripheral Nerve Society.