title: Immunoadsorption therapy for a child with Guillain-Barre syndrome subsequent to Mycoplasma infection: a case study.
abstract: We report an 11-year-old boy with apparently the motor axonal form of Guillain-Barre syndrome (GBS) who presented with severe paralysis and respiratory insufficiency by the 3rd day from onsets of symptoms. His serum anti-Mycoplasma pneumoniae and anti-Galactocerebroside (Gal-C) IgM antibody were significantly elevated. Magnetic resonance imaging, following contrast injection, showed enhancement of the cauda equina. The patient responded quickly and dramatically to immunoadsorption therapy using a tryptophan-immobilized column, with recovery of respiratory failure and muscle strength, dominantly in the left extremities. Immunoadsorption therapy should be considered for patients with anti Gal-C antibody-associated GBS.
authors.affiliation: Department of Pediatrics and Developmental Medicine, Gunma University Graduate School, 3-39-15 Showa-machi, Maebashi, Gunma 371, Japan. harakawa@showa.gunma-u.ac.jp
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Arakawa
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yuhara
authors.forename: Makoto
authors.initials: M
authors.lastname: Todokoro
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mochizuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tokuyama
authors.forename: Fumio
authors.initials: F
authors.lastname: Kunimoto
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morikawa
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D002420:Cauda Equina / Q000473:pathology; D002648:Child; D005699:Galactosylceramides / Q000276:immunology; D020275:Guillain-Barre Syndrome / Q000276:immunology / Q000382:microbiology* / Q000628:therapy*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007163:Immunosorbent Techniques; D008279:Magnetic Resonance Imaging; D008297:Male; D009177:Mycoplasma pneumoniae / Q000276:immunology*; D010956:Plasmapheresis; D011019:Pneumonia, Mycoplasma / Q000150:complications* / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D005699:Galactosylceramides; D007075:Immunoglobulin M; C002454:galactocerebroside