Abstract: Objective To investigate the significance of peripheral blood lymphocyte subsets and cerebrospinal fluid protein in evaluating the early stage of acute Guillain-Barré syndrome (GBS) in children. Methods The clinical data of 60 hospitalized children diagnosed with GBS from November 2011 to March 2020 were retrospectively analyzed. The children were divided into mild group and severe group according to the condition at admission and Hughes scale. The age, gender, presence of pre-infection, peripheral blood lymphocyte subsets, and cerebrospinal fluid protein levels between the two groups were compared. Multivariate logistic regression was used to analyze the risk factors of severe GBS. Results Among the 60 children (33 boys and 27 girls, median age=5.30 years), 33 (55%) had severe GBS. Compared with the mild group, the levels of CD3+ in peripheral blood of the severe group were lower, while the levels of CD3- CD19+ and total protein/microalbumin in cerebrospinal fluid were higher, and the differences were statistically significant (P< 0 . 05 ). Multivariate logistic regression analysis showed that the total protein/microalbumin levels in cerebrospinal fluid was a risk factor for severe GBS (P< 0 . 05 ). Conclusions There are disorders of lymphocyte subsets in both mild and severe GBS in the acute stage. Monitoring the levels and classification of cerebrospinal fluid protein in the acute phase of GBS helps assess the severity of the children’s condition.

Key words: Guillain-Barré syndrome; lymphocyte subset; cerebrospinal fluid protein; neuroimmune response