[Plasmapheresis in Guillain-Barre syndrome].
OBJECTIVE
To evaluate the efficacy of early therapeutic plasmapheresis in severely affected patients with Guillain-Barré syndrome (GBS).


METHODS
Patients between 16 to 70 years of age, with GBS according to NINCDS criteria, in stage > or = 3 of Huges severity score and with less than 7 days of onset of symptoms were admitted for therapeutic plasmapheresis. All patients completed a total of five sessions of plasma exchange every other day using 25% albumin and saline in a 1:1 proportion. Follow-up was performed for 6 months. Friedman and Wilcoxon tests were done to establish differences within groups.


RESULTS
A total of 34 patients were admitted to the study. The time span between onset of symptoms and admission to the study was 4 days (median). Fourteen (41%) required mechanical ventilation. Clinical progression of the syndrome was observed during the first two sessions of plasma-pheresis. Improvement in motor function by Huges score was observed only after fourth session of plasma exchange (p < 0.05). Two patients did not improve, and one died.


CONCLUSIONS
Clinical improvement in GBS during early therapeutic plasmapheresis occurs only after the fourth session of plasma exchange.
Carbajal-Ramírez
Angélica
A
Servicio de Neurología, Dr. Bernardo Sepúlveda G. del Centro Médico Nacional Siglo XXI, IMSS, México, D.F.
Castañón-González
Jorge Alberto
JA
Osvaldo-Talavera
Juan
J
de la Torre-Nieto
María Luisa
ML
León-Gutiérrez
Marco Antonio
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D020275:Guillain-Barre Syndrome / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis