{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:28:21Z","timestamp":1784204901745,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,7,30]],"date-time":"2023-07-30T00:00:00Z","timestamp":1690675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,7,30]],"date-time":"2023-07-30T00:00:00Z","timestamp":1690675200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Guillain\u2010Barr\u00e9 syndrome (GBS) is an immune\u2010mediated polyradiculoneuropathy and the most common cause of acute flaccid paralysis worldwide. GBS classically presents with acute, progressive, ascending weakness, reduced to absent reflexes, and albuminocytological dissociation on cerebrospinal fluid (CSF) analysis. Botulism is a neurotoxin\u2010mediated acute descending flaccid paralysis with cranial nerve palsies and dysautonomia. Botulism in adults is caused by ingestion\/inhalation of botulinum toxin or wound infection with\n                    <jats:italic>Clostridium botulinum<\/jats:italic>\n                    . Both GBS and botulism can rapidly precipitate respiratory failure; thus, prompt diagnosis and treatment are crucial to mitigate poor outcomes. Herein, we describe a case of botulism initially diagnosed as GBS given classic laboratory features, and describe the importance of careful consideration of the most appropriate therapeutic modalities in cases of acute flaccid paralysis, particularly regarding empiric administration of botulinum antitoxin and use of intravenous immune globulin in lieu of plasma exchange for potential GBS to prevent removal of antitoxin.\n                  <\/jats:p>","DOI":"10.1002\/jca.22081","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T02:28:52Z","timestamp":1690770532000},"page":"760-763","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Botulism mimicking\n                    <scp>Guillain\u2010Barre<\/scp>\n                    syndrome: The question of plasma exchange in an unusual case of acute paralysis"],"prefix":"10.1002","volume":"38","author":[{"given":"Juan J.","family":"Silva Campos","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5526-966X","authenticated-orcid":false,"given":"Elizabeth","family":"Abels","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7271-7447","authenticated-orcid":false,"given":"Henry M.","family":"Rinder","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Internal Medicine (Hematology) Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1785-2245","authenticated-orcid":false,"given":"Christopher A.","family":"Tormey","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5719-9685","authenticated-orcid":false,"given":"Jeremy W.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00517\u20101"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000814"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101693005"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7002a1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.22043"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.121"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102013\u2010305397"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102012\u2010302824"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010019\u20100250\u20109"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol\u20102018\u2010001891"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)09095-2"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001798.pub3"},{"key":"e_1_2_6_14_1","unstructured":"FoodUS AdministrationD.BAT\u00ae [Botulism Antitoxin Heptavalent (A B C D E F G)\u2014(Equine)] Package Insert.https:\/\/www.fda.gov\/media\/85514\/download#:~:text=BAT\u2010 %5BBotulism%20Antitoxin%20Heptavalent%20(A%2C%20B%2C%20C%2C%20D in%20adults%20and%20pediatric%20patientsAccessed July 14 2023."},{"key":"e_1_2_6_15_1","unstructured":"US Food & Drug Administration.BabyBIG [Botulism Immune Globulin Intravenous (Human) (BIG\u2010IV)] Package Insert.https:\/\/www.fda.gov\/media\/150406\/download#:~:text=BabyBIG%C2%AE%2C%20Botulism%20Immune%20Globulin below%20one%20year%20of%20ageAccessed July 14 2023."},{"key":"e_1_2_6_16_1","unstructured":"California Department of Public Health.Infant botulism treatment and prevention program.https:\/\/www.cdph.ca.gov\/Programs\/CID\/DCDC\/Pages\/ObtainBabyBig.aspx#:~:text=BabyBIG%C2%AE%2C%20Botulism%20Immune%20Globulin botulism%20types%20A%20and%20BAccessed July 14 2023."}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.22081","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jca.22081","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.22081","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:18:43Z","timestamp":1771251523000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.22081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,30]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/jca.22081"],"URL":"https:\/\/doi.org\/10.1002\/jca.22081","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,30]]},"assertion":[{"value":"2023-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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