We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Outcome of Guillain–Barré syndrome following intravenous immunoglobulin compared to natural course.
- Authors
Kalita, Jayantee; Misra, Usha K.; Chaudhary, Sarvesh K.; Das, Moromi; Mishra, Anadi; Ranjan, Abhay; Kumar, Mritunjai
- Abstract
Background and purpose: Intravenous immunoglobulin (IVIg) is recommended in Guillain–Barré syndrome (GBS), but its efficacy may vary in different subtypes. We report the outcomes of patients with GBS following IVIg treatment compared to the natural course (NC). We also compare the effect of IVIg treatment in different subtypes of GBS. Methods: From a cohort of 528 GBS subjects, we have extracted 189 patients who received IVIg and compared their outcomes with 199 age‐ and peak disability‐matched patients who did not receive IVIg, plasmapheresis, or corticosteroid. Disability was assessed using the 0–6 Guillain–Barré Syndrome Disability Scale (GBSDS). Clinical and neurophysiological subtypes were recorded. The primary outcome was functional disability at 6 months, which was categorized as complete (GBSDS ≤ 1), partial (GBSDS 2–3), or poor (GBSDS > 3). The secondary outcomes were in‐hospital death, duration of hospitalization, and mechanical ventilation. Results: In‐hospital death (2.6% vs. 2%, p = 0.74) and 3‐month poor recovery (20.7% vs. 18%) were similar in the IVIg and NC groups. At 6 months, however, a lesser proportion of patients in the IVIg group had poor recovery (2.2% vs. 8.3%, p = 0.026). The outcomes of IVIg and NC were compared in 72 acute motor axonal neuropathy (AMAN) and 256 acute inflammatory demyelinating polyradiculoneuropathy (AIDP) patients. IVIg therapy did not alter the outcome in AMAN but resulted in a lesser proportion of poor recovery at 6 months in AIDP (0.8% vs. 6.6%, p = 0.03). Conclusions: IVIg is beneficial in AIDP variants of GBS but not in the AMAN subtype. A customized treatment may be cost‐effective until a randomized controlled trial is conducted in AMAN.
- Subjects
GUILLAIN-Barre syndrome; INTRAVENOUS immunoglobulins; MOTOR neuron diseases; RANDOMIZED controlled trials
- Publication
European Journal of Neurology, 2022, Vol 29, Issue 10, p3071
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/ene.15500