Biomaterial Database

Intravenous immune globulin in the Guillain-Barré syndrome. 1994

F G van der Meché

Department of Neurology, University Hospital Dijkzig, Rotterdam, The Netherlands.

Guillain-Barré syndrome is an acute immune-mediated polyneuropathy with a severe clinical course. Plasma exchange (PE) was the first proven effective treatment ameliorating morbidity and outcome. However, it is not readily available and contraindications and complications frequently occur. High-dose intravenous immune globulin (IVIG) was demonstrated recently to be at least as effective and possibly more effective. The evidence is summarized in this article. Although specific treatment is now available, a proportion of patients do deteriorate with either IVIG (25%) or PE (34%) over the first 2 weeks after onset of treatment. A new dilemma has therefore arisen: is it worthwhile to switch therapy in patients who show further deterioration during therapy? As will be discussed, only a pragmatic approach is possible for the moment. In general it will be most effective to give just one full dose of IVIG or, alternatively, a full course of PE. More effective treatments are still being developed. The results of a pilot study of IVIG combined with high-dose methyl-prednisolone are promising and warrant a large scale clinical trial for further confirmation.

UI	MeSH Term	Description	Entries
D008775	Methylprednisolone	A PREDNISOLONE derivative with similar anti-inflammatory action.	6-Methylprednisolone,Medrol,Metipred,Urbason,6 Methylprednisolone
D010951	Plasma Exchange	Removal of plasma and replacement with various fluids, e.g., fresh frozen plasma, plasma protein fractions (PPF), albumin preparations, dextran solutions, saline. Used in treatment of autoimmune diseases, immune complex diseases, diseases of excess plasma factors, and other conditions.	Exchange, Plasma,Exchanges, Plasma,Plasma Exchanges
D011129	Polyradiculoneuropathy	Diseases characterized by injury or dysfunction involving multiple peripheral nerves and nerve roots. The process may primarily affect myelin or nerve axons. Two of the more common demyelinating forms are acute inflammatory polyradiculopathy (GUILLAIN-BARRE SYNDROME) and POLYRADICULONEUROPATHY, CHRONIC INFLAMMATORY DEMYELINATING. Polyradiculoneuritis refers to inflammation of multiple peripheral nerves and spinal nerve roots.	Autoimmune Demyelinating Disease, Peripheral,Demyelinating Autoimmune Disease, Peripheral,Demyelinating Disease, Peripheral Autoimmune,Peripheral Autoimmune Demyelinating Disease,Polyradiculoneuritis,Polyradiculoneuritides,Polyradiculoneuropathies
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016756	Immunoglobulins, Intravenous	Immunoglobulin preparations used in intravenous infusion, containing primarily IMMUNOGLOBULIN G. They are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels including pediatric AIDS; primary HYPERGAMMAGLOBULINEMIA; SCID; CYTOMEGALOVIRUS infections in transplant recipients, LYMPHOCYTIC LEUKEMIA, CHRONIC; Kawasaki syndrome, infection in neonates, and IDIOPATHIC THROMBOCYTOPENIC PURPURA.	Antibodies, Intravenous,Human Intravenous Immunoglobulin,IV Immunoglobulin,IVIG,Intravenous Antibodies,Intravenous Immunoglobulin,Intravenous Immunoglobulins,Alphaglobin,Endobulin,Flebogamma DIF,Gamimmune,Gamimmune N,Gamimune,Gamimune N,Gammagard,Gammonativ,Gamunex,Globulin-N,IV Immunoglobulins,Immune Globulin Intravenous (Human),Immune Globulin, Intravenous,Immunoglobulins, Intravenous, Human,Intraglobin,Intraglobin F,Intravenous IG,Intravenous Immunoglobulins, Human,Iveegam,Modified Immune Globulin (Anti-Echovirus Antibody),Privigen,Sandoglobulin,Venimmune,Venoglobulin,Venoglobulin-I,Globulin N,Human Intravenous Immunoglobulins,Immunoglobulin, Human Intravenous,Immunoglobulin, IV,Immunoglobulin, Intravenous,Immunoglobulins, Human Intravenous,Immunoglobulins, IV,Intravenous Immune Globulin,Intravenous Immunoglobulin, Human,Venoglobulin I