Immune globulins are effective in severe pediatric Guillain-Barre syndrome

The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guillain-Barré syndrome. They presented with mild to moderate flaccid weakness of extremities, with cranial nerve involvment (20) and sensory impairment (22). All ch...

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Bibliographic Details
Published in:Pediatric neurology 1997, Vol.16 (1), p.32-36
Main Authors: Shahar, Eli, Shorer, Zamir, Roifman, Chaim M., Levi, Yaacov, Brand, Natan, Ravid, Sarit, Gordon Murphy, E.
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Immunization, Passive
Infant
Male
Medical sciences
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurologic Examination
Neurology
Polyradiculoneuropathy - immunology
Polyradiculoneuropathy - therapy
Prospective Studies
Ventilator Weaning
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Summary:The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guillain-Barré syndrome. They presented with mild to moderate flaccid weakness of extremities, with cranial nerve involvment (20) and sensory impairment (22). All children rapidly deteriorated in 2–16 days (mean 6) to become bedridden, and 2 children also developed respiratory failure requiring artificial ventilation (Disability Grading Scale 4–5). Immune globulins were then administered at a total dose of 2 gm/kg, on 2 consecutive days, without adverse effects requiring discontinuation of therapy. Marked and rapid improvement was noted in 25 children, who improved by 1 to 2 Disability Grade Scales ⩽2 weeks after the infusion. Twenty were able to walk independently by 1 week, and 1 could be weaned off a ventilator. Eighteen children recovered by 2 weeks. The rest recuperated in a period of four months, including a child who was artificially ventilated for 4 weeks. The uniform rapid improvement and recovery associated with immune globulins contrasts with the slow recovery course in severe natural cases. We conclude that immune globulins are effective and safe in severe childhood-onset Guillain-Barré syndrome and therefore may serve as the initial treatment of choice.
ISSN:0887-8994
1873-5150
DOI:10.1016/S0887-8994(96)00253-6