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KMID : 0359719940120020289
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Journal of the Korean Neurological Association
1994 Volume.12 No. 2 p.289 ~ p.297
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Effects of Intravenous Immunoglobulin Therapy in Guillain-Barre Syndrome
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임주혁
이한보/박성호/이상수/안무영/이광호/이상복/명호진/이광우
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Abstract
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There are several reports that Guillain-Barre syndrome (GBS) is closely associated with immunologic disturbance, although the exact mechanism of GBS is not fully understood. Recently intravenous human immunoglobulin(IVIg) has boen implicated to
improve
clinical course of several immune-mediated diseases, which are resistant to conventional therapy. Authors studied retrospectively the effectiveness of IVIg therapy in GBS and compared the clinical courses in this group wih those of control GBS
goup
without IVIg therapy or plasmapheresis.
Ten subjects with GBS were treated with IVIg. IVIg fo 0.4gm/kg/day was slowly infused via parenteral route for five days as one schedule. At the time infusion, the status of GBS were regarded as moderate to severe. All GBS subjects showed arrest
of
progression and began to improve at longest from the third day of Ivig therapy. The intervals from the day of aximal neurologic disability score(NDS) to the day of 30T-decrease of maximal NDS were estimated as 10±6 days and 22±11 days,
respectively in
IVIg-treated and in control GBS group, which showed signifi cant difference(p<0.05). One patient who had been in maximal neurologic deficit 8days prior to therapy showed very poor response to IVIg therapy Another patient showed initial
improvement
after
the first cycle of IVIg therapy, and subsequently showed relapse on the 6th day of therapy. So the second cycle of IVIg therapy was needed to arrest the down-hill course.
Regarding side effects of IVIg, one patient experienced generalized itching sensation transiently without skin eruption. Another patient showed previously unreported severe neutropenia immediately after one cycle of IVIg therapy, which was
normalized 2
weeks after stopping IVIg.
We thought that IVIg therapy was effective and relatively safe to lessen neurologic deficit and to shorten clinical course during the period of acute or progressive stage of GBS.
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KEYWORD
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