Treatment-related fluctuation of Guillain-Barré syndrome associated with positive autoantibodies: a pediatric case report

Guillain–Barre syndrome (GBS) is an acute inflammatory polyneuropathy usually considered as a post-infectious autoimmune disease. It is generally monophasic, but treatment related fluctuation (TRF) and recurrences could occur. The main challenge is to differentiate TRF from acute onset chronic idiopathic demyelinating polyneuropathy (A- CIDP). These entities have different outcomes and prognosis, thus the importance of a thorough workup. Genetic and/or immunological host factors may play an important role. In this report, we describe a case of TRF_GBS associated with positive anti-GAD (Glutamate decarboxylase) and anti-VGKC (canals potassium voltages depended) autoantibodies in an 11-year-old boy. With a focus on management and differential work up. Through this case report, we aim to raise awareness among healthcare providers about this rare but potentially severe entity.