Background and Objectives

A gap exists between difficulty in diagnosis and importance of early recognition and intervention in pediatric Guillain-Barré syndrome (GBS). Therefore, this study aimed to establish a diagnostic odyssey plot that allows “at-a-glance” overview of the diagnostic odyssey of GBS in children, including overall diagnostic delay, physician-related and patient-related diagnostic delays, and length and frequency of diagnostic errors.

Methods

In this single-center retrospective cohort study, standardized data were obtained from children with GBS from 2003 to 2020. Overall diagnostic delay (time between symptom onset and diagnosis), physician-related diagnostic delay (time between the first medical visit and diagnosis), and patient-related diagnostic delay (time between symptom onset and the first medical visit) were analyzed.

Results

The study examined a total of 21 patients (11 men, median age 4.5 years). Overall, there were 40 misdiagnoses among 17 patients, while four were diagnosed correctly at the first visit. The overall diagnostic delay was 9 days [interquartile range (IQR), 6–17 days]. Physician-related diagnostic delay, but not patient-related diagnostic delay, was correlated with the overall diagnostic delay. Patients in the late-diagnosed group were more frequently misdiagnosed during their diagnostic odyssey than patients in the other groups. Risk factors associated with diagnostic delay included delayed onset of weakness and sensory deficits, absence of swallowing problems, and misdiagnosis as orthopedic disorders or viral infections.

Discussion

A unique diagnostic odyssey exists in pedaitric GBS. Several clinical risk factors were associated with the diagnostic delay.

中文翻译：

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儿童吉兰-巴利综合征的诊断之旅

背景和目标

小儿吉兰-巴利综合征 (GBS) 的诊断难度与早期识别和干预的重要性之间存在差距。因此，本研究旨在建立一个诊断奥德赛图，可以“一目了然”地概述儿童 GBS 的诊断奥德赛，包括总体诊断延迟、医生相关和患者相关的诊断延迟以及诊断延迟的长度和频率。诊断错误。

方法

在这项单中心回顾性队列研究中，获得了 2003 年至 2020 年 GBS 儿童的标准化数据。总体诊断延迟（症状出现和诊断之间的时间）、医生相关的诊断延迟（第一次就诊和诊断之间的时间）、并分析了与患者相关的诊断延迟（症状出现和第一次就诊之间的时间）。

结果

该研究总共检查了 21 名患者（11 名男性，中位年龄 4.5 岁）。总体而言，17 名患者中有 40 例误诊，而 4 例在首次就诊时诊断正确。总体诊断延迟为 9 天 [四分位距 (IQR)，6-17 天]。与医生相关的诊断延迟（而非与患者相关的诊断延迟）与总体诊断延迟相关。晚期诊断组的患者在诊断过程中比其他组的患者更容易误诊。与诊断延迟相关的危险因素包括迟发性无力和感觉缺陷、没有吞咽问题以及误诊为骨科疾病或病毒感染。

讨论

儿科 GBS 存在独特的诊断过程。一些临床危险因素与诊断延迟有关。