Guillain-Barre syndrome: A rare presentation of borderline tuberculoid leprosy with Type 1 lepra reaction

Abstract

Guillain-Barre syndrome (GBS) is an autoimmune polyradiculoneuropathy usually preceded by respiratory tract or gastrointestinal infection. The pathogenesis in GBS is based on molecular mimicry mechanism. Hansen's disease is common in India and is the most common infectious cause of neuropathy. We describe a 42-year-old man who was being treated for borderline tuberculoid leprosy and developed Type 1 lepra reaction followed by GBS and responded to plasmapheresis. Lepra reaction may lead to exposure of neural antigens, resulting in autoimmune mechanism and demyelination of peripheral nerves.