Is a second cycle of immunoglobulin justified in axonal forms of Guillain-Barré syndrome?

Arquivos de Neuro-Psiquiatria

Daniel Agustin Godoy¹  Alejandro Rabinstein¹ 

关键词: Guillain-Barré syndrome;    acute inflammatory demyelinating polyradiculoneuropathy;    flaccid acute paralysis;    immunotherapy;    immunoglobulin;    síndome de Guillain-Barré;    poliradiculoneuropatia inflamatória aguda;    paralisia flácida aguda;    imunoterapia;    imunoglobulina;   

DOI  :  10.1590/0004-282X20150136

来源: SciELO

【 摘 要 】

Objective In certain situations, severe forms of Guillain-Barré syndrome (GBS) show no response or continue to deteriorate after intravenous immunoglobulin (IVIg) infusion. It is unclear what the best treatment option would be in these circumstances.Method This is a case report on patients with severe axonal GBS in whom a second cycle of IVIg was used.Results Three patients on mechanical ventilation who presented axonal variants of GBS, with autonomic dysfunction, bulbar impairment and Erasmus score > 6, showed no improvement after IVIg infusion of 400 mg/kg/d for 5 days. After 6 weeks, we started a second cycle of IVIg using the same doses and regimen as in the previous one. On average, 5 days after the second infusion, all the patients were weaned off mechanical ventilation and showed resolution of their blood pressure and heart rate fluctuations.Conclusions A second cycle of IVIg may be an option for treating severe forms of GBS.

【 授权许可】

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