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April 1979

Fatal Guillain-Barre Syndrome With Reduced-dose Antirabies Vaccination

Author Affiliations

Natl Institute of Health of Colombia Avenida Eldorado Con Carrera 50 Zona 6 o Apartados Aeros 80080 y 80334 Bogota, DE, Colombia

Arch Neurol. 1979;36(4):254. doi:10.1001/archneur.1979.00500400108026

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To the Editor.—  Shortly before publication in the Archives of our article titled "Neuroparalytic Accidents of Antirabies Vaccination With Suckling Mouse Brain (SMB) Rabies Vaccine" (34:694-700, 1977), we had the opportunity to study a new fatal case of Guillain-Barre syndrome.

Report of a Case.—  A 71-year-old man received seven subcutaneous doses of SMB rabies vaccine for postexposure prophylaxis. The symptoms appeared six days after termination of the vaccination and the clinical picture was characterized by facial diplegia, bulbar muscle involvement, and descending quadriplegia with generalized areflexia. Cerebrospinal fluid values were normal with a slight increase of the IgG level (0.72 mg/dl). The patient was treated with high doses of corticoids and required respiratory assistance from the second day of evolution. Two weeks after the onset of the symptoms, the patient died suddenly. Autopsy was not performed. Virological studies of the vaccine batch were done with negative results. Encephalitogenic activity of

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