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research-project
Research project

Guillain Barré (GBS) Mimics Study

Status: Ongoing

A multicenter, prospective, observational cohort study on clinical and biological diagnostic markers for the Guillain-Barré Syndrome (GBS).

What we do

About our project

Rationale:

The Guillain-Barré syndrome (GBS) is a severe immune-mediated polyneuropathy. GBS has a rapidly progressive disease course and patients can suffer from respiratory failure or autonomic dysfunction.  Early recognition is of great importance for adequate monitoring and treatment but can be difficult due to a great diversity in clinical presentation and an extensive differential diagnosis. Unfortunately, there are currently no specific diagnostic tests for GBS. The cerebrospinal fluid can be investigated, but this is primarily intended to exclude other causes. In addition, the nerve conduction studies can be normal in the acute phase. Previous studies have shown that GBS is diagnosed relatively late, particularly in young children. A late diagnosis can have fatal consequences in GBS.

 

 

Objectives:

The GBS Mimics study aims to improve the early and accurate diagnosis of GBS.  The study objective is to describe the current diagnostic work-up and actual differential diagnosis of GBS and the distinguishing clinical features and biomarkers between:

 

  • Patients with a GBS mimic, i.e. a condition that initially resembled GBS but ultimately turned out not to be GBS
  • Patients diagnosed with GBS

The GBS Mimics study is an initiative from the Haga Hospital (The Hague) and Erasmus MC and conducted in collaboration with several other hospitals in The Netherlands. 

 

Study design:

The GBS Mimics is a multi-center prospective, observational, systematic cohort study of consecutive patients with GBS or a GBS mimic. To prevent bias of reported frequency of GBS and GBS mimics, all patients who meet the inclusion and exclusion criteria may participate in the study. Patients who can participate include all patients in whom GBS has been considered as a diagnosis by the treating physician. Patients can be included only after consultation of the GBS expertise center at Erasmus MC.

Data from both adults and children will be collected but will be analyzed and published separately.

 

 

Expected results and planning:

GBS Mimics will result in a prospective, standardized clinical database and biobank from at least 300 patients with either GBS or a GBS mimic.  The biomaterials will be used to search for diagnostic tests for GBS.  We aim to use these data to  improve the guidelines for the diagnosis and management of GBS.

Our research focus

Objectives:

More specifically, the aims of this study are:

  • Determining the differential diagnosis of GBS in the Netherlands.
  • Determining the prevalence of GBS mimics.
  • Determine the time needed to make the correct diagnosis after the symptoms have started and after a first visit to a doctor ("diagnostic delay").
  • Determine the factors that influence this "diagnostic delay".
  • Determining the clinical characteristics that discriminate between GBS and GBS mimics and how often and in which patients they occur.
  • Determining the findings of additional research that discriminate between GBS and GBS mimics and how often and in which patients they occur.
  • Validating the specificity of the Brighton criteria for GBS.
  • Collecting serum and CSF samples from patients with GBS and GBS mimics with the aim of developing biomarkers that differentiate between GBS and GBS mimics.
  • Developing a guideline for clinical practice that helps distinguish between GBS and GBS mimics.

Collaborations

Internal collaborations:

  • Dr. M.C.Y de Wit, Kinderneuroloog, Erasmus MC Sophia kinderziekenhuis, Rotterdam
  • Drs. J. Roodbol, Arts-onderzoeker, Erasmus MC Sophia kinderziekenhuis, Rotterdam
  • Drs. J.C. Verboon, Arts-onderzoeker, Erasmus MC , Rotterdam
  • Dr. B.C. Jacobs, Neuroloog-Immunoloog, Erasmus MC, Rotterdam

 

External collaborations:

  • Drs. M.M. Eysink Smeets, Arts-assistent Neurologie, HagaZiekenhuis, Den Haag
    Drs. A. Buizert, Arts-assistent Neurologie, HagaZiekenhuis, Den Haag
  • Drs. W. Amerika, Arts-assistent Neurologie, Hagaziekenhuis, Den Haag
  • Dr. S.F.T.M. de Bruijn, Neuroloog, HagaZiekenhuis, Den Haag
  • Dr. P.W. Wirtz, Neuroloog, HagaZiekenhuis, Den Haag

Our team

Principal investigator

Prof. dr. Bart Jacobs

PhD-students

drs. Bianca van den Berg

drs. Christine Verboon

drs. Joyce Roodbol

drs. Alex Doets

drs. Sonja Leonhard

 

Biobank

Ruth Huizinga

Wouter van Rijs

Anne Tio-Gillen

 

Research-coordinator

Marieke van Woerkom

 

Corresponding address

gbsstudies@erasmusmc.nl