Pilot study of a new treatment concept for acute Guillain-Barré syndrome.
The pathogenesis of acute Guillain-Barré syndrome (GBS) is unknown as yet. Numerous clinical and experimental data suggest an autoimmune disorder. Controlled multicenter trials have demonstrated the efficacy of plasma exchange and intravenous immunoglobulin (IgG). A combination of these treatments appears to be a promising concept. We assume that initial selective adsorption treatment eliminates the postulated circulating pathogenetic agent and thereby allows for a more effective immunomodulation by the subsequent administration of i.v. IgG. In a pilot study of 30 patients (11 plasma exchange, 7 selective adsorption, and 12 patients treated with selective adsorption and subsequent administration of i.v. IgG) we found no significant differences for the variables including disability on admission, maximal disability, change of disability during treatment, and disability on discharge. Moreover, we found no apparent differences with respect to tolerance of the procedures or procedural side-effects. We conclude from these preliminary findings that these treatment regimens are viable and safe procedures and result in similar clinical improvement. Statistical evaluation of the efficacy of this treatment concept can only be done after a multicenter study of a large patient group.
Haupt
W F
WF
Department of Neurology, University of Cologne, Germany.
Borberg
H
H
Rosenow
F
F
D000208:Acute Disease; D000327:Adsorption; D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D010951:Plasma Exchange; D011129:Polyradiculoneuropathy / Q000628:therapy*