{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T14:36:14Z","timestamp":1759847774579},"reference-count":0,"publisher":"Scientific Scholar","issue":"02","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":3057,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Neurosciences in Rural Practice"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Guillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF. <\/jats:p>","DOI":"10.4103\/0976-3147.83585","type":"journal-article","created":{"date-parts":[[2011,8,9]],"date-time":"2011-08-09T06:02:15Z","timestamp":1312869735000},"page":"168-170","source":"Crossref","is-referenced-by-count":6,"title":["Treatment-related fluctuation in Guillain-Barre syndrome"],"prefix":"10.25259","volume":"02","author":[{"given":"Thirunavukkarasu","family":"Thivakaran","sequence":"additional","affiliation":[{"name":"Institute of Neurology, National Hospital of Sri Lanka, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjanie","family":"Gamage","sequence":"additional","affiliation":[{"name":"Institute of Neurology, National Hospital of Sri Lanka, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inuka Kishara","family":"Gooneratne","sequence":"additional","affiliation":[{"name":"Institute of Neurology, National Hospital of Sri Lanka, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,11,13]]},"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.4103\/0976-3147.83585.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T04:24:58Z","timestamp":1691209498000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/treatment-related-fluctuation-in-guillain-barre-syndrome\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2019,11,13]]},"published-print":{"date-parts":[[2011,7]]}},"URL":"https:\/\/doi.org\/10.4103\/0976-3147.83585","relation":{},"ISSN":["0976-3147","0976-3155"],"issn-type":[{"value":"0976-3147","type":"print"},{"value":"0976-3155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,7]]}}}