Immune-Mediated

GBS is a rare manifestation of serum sickness with a delayed hypersensitivity reaction, triggered by catastrophic over-stimmulation of the immune system. It is an immune-mediated type of delayed allergic response secondary to certain medications, or an immune mediated neuropathic reaction to contraindicated medications, or both. The pathogenesis of a neuropathic reaction involves an autoimmune reaction to peripheral nerve tissue. Several variants of GBS are recognized and clinically similar states leading to catastrophic decline have been reported to occur with a variety of drugs and biologics.

The most serious complications of serum sickness are nerve conditions such as Guillain-Barré syndrome, and peripheral neuritis. Many of the more commonly reported reactions include hypotonia, dysarthria, dysphasia, somnolence, dizziness, paresthesia, nausea, vomiting, and headache, are clearly drug related.

Central nervous system complications of many pharma-agents include aseptic meningitis and Guillain-Barré syndrome. While GBS has been found more freequently than expected in cancer patients, this association is extremely rare. There have been rare cases of GBS caused by chemotherapy, and possible associations with radiation therapy. GBS can occur in patients with severe T-cell suppression (T-cells literally become worn out) as a consequence of incomplete recovery following infectious, or chemotherapeutic agents, especially radiation which preferentially suppress T-lymphocyte responses. T-cells are usually the first to fall in radiation therapy. Thus lymphocytopenia and incomplete recovery are consistent with immunocompromise in patients with GBS.

GBS is a catastrophic condition which can be triggered by something as innocuous as a cold or stomach upset. Even the flu jab can cause it. GBS can also be triggered by simple medications for something as common and inescapable as a cold virus. Another is that a particular medication, substance or combination may be the real cause of these disorders, but are often misdiagnosed, or overlooked as a cause. GBS is an uncommon paralysing illness, caused by autoimmune inflammation of nerves, which most often follows a therapeutic regimen for a "flu-like illness".

GBS is caused by an immune system response to a trigger, such as 'drug-drug' interaction, with possible additive effects when used in combination or concurrently as part of a drug regimen. It occurs when the immune system mistakenly attacks the nerves in the lower back, stripping them of their protective myelin sheath. This causes these long nerves to 'short circuit' and cause changes in the sensation and function of the body. Paralysis results because nerve signals can no longer pass to muscles.

Healthy nerves are wrapped in an outer coating known as myelin which is similar to the plastic insulation wrapped around a wire. In cases of GBS, the myelin is damaged, and without this coating, the nerves can no longer send messages or they send weaker messages, which may result in tingling, numbness, or paralysis.

Cross-reactions between penicillin and sulfa-drugs are common triggers of drug-induced GBS serum sickness, and fixed drug eruptions. Cipro and Septra DS have been implicated high on the order of major offenders in drug-induced GBS. It is also well documented that Cipro causes drug-induced serum sickness which can rapidly progress to Guillain-Barré syndrome. Bactrim has also been implicated high on the order of major offenders in drug-induced GBS.

Medications with drug-induced reduction of oxygen intake also become possible or contributing factors, or underlying causes of Guillain-Barre Syndrome, but are often misdiagnosed or overlooked as a cause. Vaccines, broad spectrum antibiotics, and "virus in stealth" (to help kill cancer cells) are themselves an onslaught on the immune system which can cause serum sickness leading to "provocation", the hallmark of the Guillain-Barré syndrome.