Immune globulins are effective in severe pediatric Guillain-Barre syndrome

Eli Shahar, Zamir Shorer, Chaim M. Roifman, Yaacov Levi, Natan Brand, Sarit Ravid, E. Gordon Murphy

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guillain-Barre syndrome. They presented with mild to moderate flaccid weakness of extremities, with cranial nerve involvment (20) and sensory impairment (22). All children rapidly deteriorated in 2-16 days (mean 6) to become bedridden, and 2 children also developed respiratory failure requiring artificial ventilation (Disability Grading Scale 4-5). Immune globulins were then administered at a total dose of 2 gm/kg, on 2 consecutive days, without adverse effects requiring discontinuation of therapy. Marked and rapid improvement was noted in 25 children, who improved by 1 to 2 Disability Grade Scales ≤2 weeks after the infusion. Twenty were able to walk independently by 1 week, and 1 could be weaned off a ventilator. Eighteen children recovered by 2 weeks. The rest recuperated in a period of four months, including a child who was artificially ventilated for 4 weeks. The uniform rapid improvement and recovery associated with immune globulins contrasts with the slow recovery course in severe natural cases. We conclude that immune globulins are effective and safe in severe childhood-onset Guillain- Barre syndrome and therefore may serve as the initial treatment of choice.

Original languageEnglish
Pages (from-to)32-36
Number of pages5
JournalPediatric Neurology
Volume16
Issue number1
DOIs
StatePublished - 1 Jan 1997
Externally publishedYes

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