Human immune globulin infusion in Guillain-Barré syndrome: worsening during and after treatment.
Because of an unexpectedly high rate of worsening, we report the results of treatment of Guillain-Barré syndrome with a standard regimen of human immune globulin (HIG) in 15 consecutive patients. Patients were treated with 1.5 g/kg HIG for 4 days beginning a mean of 7 days after the first symptoms. Eight stabilized or improved, but seven deteriorated during or within the first 5 days after treatment, and four remained ventilator-dependent for at least 2.5 months. One had a severe relapse 5 weeks after treatment. Five patients subsequently received plasma exchange and two improved. Our experience varies from previous reports that have endorsed HIG treatment for Guillain-Barré syndrome.
Castro
L H
LH
Neurology Service, St. Elizabeth's Hospital, Boston, MA 02135.
Ropper
A H
AH
D000200:Action Potentials; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D011129:Polyradiculoneuropathy / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors
D007136:Immunoglobulins