Long-term prognosis for Guillain-Barré syndrome: evaluation of prognostic factors and clinical experience of automated double filtration plasmapheresis.
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.
Cheng
Ben-Chung
BC
Division of Nephrology, Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan.
Chang
Wen-Neng
WN
Chen
Jin-Bor
JB
Chee
Esther Chung-Yin
EC
Huang
Chi-Ren
CR
Lu
Cheng-Hsien
CH
Chang
Chin-Jung
CJ
Hung
Pi-Lien
PL
Chuang
Yao-Cheng
YC
Lee
Chien-Te
CT
Lee
Ping-Yu
PY
Wang
Kuo-Wei
KW
Chang
Hsueh-Wen
HW
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
D016756:Immunoglobulins, Intravenous