[Immunotherapy of chronic Guillain-Barré syndrome with high dose IgG and cyclosporin A. Case report, review of the literature and perspectives].
We report about the three-year treatment of a patient with chronic relapsing Guillain-Barré syndrome (GBS), who, simultaneously, suffered from benign gammopathy. A casual relationship between the two diseases could not be proven, since specific antimyeline antibodies could not be found. Five severe bouts of the disease occurred during the observation period, only the first two relapses, however, showed improvement with cortisone treatment, while the latter did not so. High dosages of 7S-immunoglobuline, by contrast, led to a rapid improvement during each of the subsequent relapses. The additional therapy with ciclosporine A kept the patient free from neurological deficits for more than six months now. The mechanisms of various immunological therapeutic approaches are discussed, particularly as an alternative to plasmapheresis. Our observation, as well as theoretical considerations, suggest the aforementioned immunological treatment being promising in chronic GBS.
Müllges
W
W
Neurologische Klinik, Klinikum der RWTH, Aachen.
Ringelstein
E B
EB
Sommer
C
C
Biniek
R
R
Glöckner
W M
WM
D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage; D002908:Chronic Disease; D003524:Cyclosporins / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007167:Immunotherapy / Q000379:methods*; D011129:Polyradiculoneuropathy / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D013497:Sural Nerve / Q000473:pathology
D003524:Cyclosporins; D007074:Immunoglobulin G; D011239:Prednisolone; D001379:Azathioprine
Immuntherapie des chronischen Guillain-Barré-Syndroms mit Hochdosis-IgG und Ciclosporin A. Kasuistik, Literaturübersicht und Ausblick.