Pune: Unusual GBS Case with Abdominal Symptoms Stuns Doctors at MJM Hospital
Pune: In a rare and surprising medical case, doctors at MJM Hospital encountered an unusual presentation of Guillain-Barré Syndrome (GBS) in a 45-year-old woman, challenging conventional diagnostic approaches. Typically characterized by ascending paralysis starting in the legs, GBS in this patient manifested primarily through severe abdominal symptoms, including persistent vomiting and intestinal dysfunction, rather than the classic neurological signs.
The patient, a resident of Ahilyanagar with a history of epilepsy, was admitted on January 23 after three days of continuous vomiting. Initial suspicions of a gastrointestinal (GI) disorder led to a CT scan, which revealed a severely distended colon and impacted fecal matter. Despite treatment for the GI condition, her vomiting persisted, and she developed weakness in her lower limbs and drowsiness.
Further tests, including a brain scan, showed no immediate cause for her worsening condition. It was neurologist Dr. Avanti Biniwale who suggested GBS as a potential diagnosis. An electromyography (EMG-NCV) test confirmed nerve damage consistent with GBS, and the patient was started on intravenous immunoglobulin (IVIG), the standard treatment for the condition. However, her health remained precarious due to excessive stomach fluid retention.
Faced with no improvement, the medical team decided to perform a high-risk abdominal surgery, during which they discovered a severely distended duodenum, likely caused by GBS affecting intestinal movement. A bypass surgery (gastrojejunostomy) was successfully performed, and the patient’s condition gradually improved. She was discharged on February 26, more than a month after her admission.
Dr. Biniwale emphasized the importance of considering neurological causes for unexplained gastrointestinal symptoms, highlighting the need for an open-minded approach in diagnosing complex cases. This rare “abdominal variant” of GBS has added a new dimension to understanding the disease, particularly in the context of Pune’s ongoing GBS outbreak.
