title: Long-term prognosis for Guillain-Barré syndrome: evaluation of prognostic factors and clinical experience of automated double filtration plasmapheresis.
abstract: Sixty patients with Guillain-Barré syndrome (GBS), aged 16-83 years, have been identified over a period of 7 years. Of 60 patients, 30 received the double filtration plasmapheresis (DFP), 4 received intravenous immunoglobulin, and the other 26 received supportive care only. Therapeutic outcomes at 1 year were determined using a modified Barthel index. At a follow-up of 1 year or longer, 31 patients (52%) had recovered, 24 (40%) had residua, and 5 (8%) had died. According to the statistical analysis, disability at the nadir and electrophysiological signs significantly influenced the long-term outcomes. Complications associated with DFP procedures included physiologic change, technique-related complications, and vascular access-related complications. None of our patients had fatal complications related to DFP treatment. Contrary to the established belief that the disease has a favorable outcome, several hospital-treated patients may still die or present residua even several months after the onset of symptoms. Because disability at the nadir influences the outcomes, early diagnosis and choice of appropriate treatment, which might include DFP, to prevent further neurological deficits, are essential to maximize the potential for survival.
authors.affiliation: Division of Nephrology, Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
authors.forename: Ben-Chung
authors.initials: BC
authors.lastname: Cheng
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.forename: Jin-Bor
authors.initials: JB
authors.lastname: Chen
authors.forename: Esther Chung-Yin
authors.initials: EC
authors.lastname: Chee
authors.forename: Chi-Ren
authors.initials: CR
authors.lastname: Huang
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Chang
authors.forename: Pi-Lien
authors.initials: PL
authors.lastname: Hung
authors.forename: Yao-Cheng
authors.initials: YC
authors.lastname: Chuang
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
authors.forename: Ping-Yu
authors.initials: PY
authors.lastname: Lee
authors.forename: Kuo-Wei
authors.initials: KW
authors.lastname: Wang
authors.forename: Hsueh-Wen
authors.initials: HW
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis / Q000009:adverse effects / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous