Management of Guillain–Barré syndrome with plasmapheresis or immunoglobulin: our experience from a tertiary care institute in South India

Renal Failure ◽  
2014 ◽  
Vol 36 (5) ◽  
pp. 732-736 ◽  
Author(s):  
C. Krishna Kishore ◽  
J. Vijayabhaskar ◽  
R. Vishnu Vardhan ◽  
V.V. Sainaresh ◽  
P. Sriramnaveen ◽  
...  
1992 ◽  
Vol 26 (1) ◽  
pp. 32-33 ◽  
Author(s):  
Miguel Urtasun ◽  
Adolfo López de Murrain ◽  
Nieves Carrera ◽  
José F. Martí-Massó ◽  
Gonzalo López de Dicastillo ◽  
...  

OBJECTIVE: To evaluate the efficacy of high-dose intravenous gammaglobulin (IGIV) versus plasmapheresis in patients with severe Guillain-Barré syndrome (GBS) and compare the costs of both treatments. DESIGN: Retrospective review of all severely disabled GBS patients admitted between January 1 and December 31, 1990. SETTING: Neurologic unit of a tertiary-care center. PATIENTS: Six patients fulfilling the criteria for the diagnosis of GBS agreed upon by the ad hoc National Institute of Neurological and Communicative Disorders and Stroke committee. INTERVENTION: Four patients treated with plasmapheresis underwent three to six sessions of plasma exchange. Two patients received IGIV 0.4 g/kg/d administered over a five-day period. MAIN OUTCOME MEASURES: Recovery time, functional assessment (performed according to the grading scale used in the North American trial) at 30, 60, and 90 days after treatment. Cost of plasmapheresis, IGIV, and bed/day were compared. RESULTS: Clinical recovery appeared to be faster and more complete in the IGIV group than in the plasmapheresis group. No adverse reactions related to IGIV treatment appeared. The total cost was greater in the plasmapheresis group. CONCLUSIONS: These preliminary results suggest that IGIV may be more beneficial and less expensive than plasmapheresis in treatment of GBS. Definitive conclusions regarding the efficacy of IGIV in GBS will need to await the final analysis of the Ducht randomized multicenter trial comparing IGIV with plasmapheresis.


2019 ◽  
Vol 5 (1) ◽  
pp. 2-7
Author(s):  
Bithi Debnath ◽  
Mohammad Enayet Hussain ◽  
Nazmul Haque ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
...  

Background: Guillain Barre Syndrome (GBS) is an acute polyradiculopathy which is quite common in all ages. Objective: The aim of this study was to evaluate the clinical and electrophysiologicaspects of Guillain Barre Syndrome (GBS) in children. Methodology: This cross-sectional study was carried out in the Department of Neurophysiology of National Institute of Neurosciences and Hospital, Bangladesh from July 2016 to June 2018. Patients under 18 years of age fulfilling Brighton diagnostic criteria for GBS were included in this study. These patients were evaluated by detailed history, physical examination, and electrophysiological findings. Results: A total of 82 patients of GBS were enrolled in this study. The mean age was 12.93± 5.02 years (range 1 to<18 years). Most of the patients were male (64.6%) and from the middle-income group (70.73%). About Fourty eight percent of patients had a history of preceding illness among which gastrointestinal infection(24.3%) was the most common. Tingling and paresthesiaswas complained by 32.4% of patients as the first symptom. AMAN(61%) was the most common GBS variant followed by AIDP(26.8%). 9 (11%) patients needed ICU support among them AIDP was more frequent. Conclusion: AMAN is the most common variant among children in this population by electrophysiologic testing. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 2-7


2021 ◽  
Vol 10 (15) ◽  
pp. 1069-1073
Author(s):  
Moni Mukesh Udani ◽  
Akanksha Jivrag Neogi ◽  
Shweta Wasudeo Dhote ◽  
Iqbal Singh

BACKGROUND Therapeutic plasma exchange is a process where the blood collected from patient is passed through an apheresis instrument where the plasma is removed and discarded and reinfusion of blood cells done with replacement fluids like plasma or albumin to the patient.1 It is to remove pathogenic autoantibodies, immune complexes, cryoglobulins and toxins present in the plasma. Plasma exchange is considered effective and cheaper immunomodulatory treatment when compared to intravenous immunoglobulin (IVIG). 2 We present our institutional experience with therapeutic plasma exchange (TPE) in treatment of various non-neurological and neurological diseases. Our study was conducted to assess the indications, complications and outcome of TPE in the treatment of patients. METHODS A retrospective study of TPE procedures was carried out in the Department of Immunohaematology and blood transfusion, M.G.M Medical College and Hospital, Navi Mumbai from June 2018 to June 2020. A total of 45 procedures were performed among 13 patients between 4 years of age to 66 years of age. Clinical parameters were checked, and laboratory investigations were done before the procedure. Data was collected from the requisition forms by the clinicians and the apheresis database. RESULTS A total of 47 procedures were carried out among 13 patients. TPE is a safe and effective procedure for treating patients with neurologic and non-neurological diseases. Most common indication was Guillain Barre syndrome followed by myasthenia gravis. Incidence of adverse reactions was 7.6 %. CONCLUSIONS TPE is a safe and effective procedure for treating patients with neurologic and nonneurological diseases. It benefited 10 out of 13 patients, and they showed complete recovery. KEY WORDS Therapeutic Plasma Exchange, Guillain Barre syndrome


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