JNNP: Intravenous immunoglobulin for mild Guillain-Barr syndrome: an international observational study

Approximately 20%-40% of patients with Guillain-Barr syndrome (GBS) do not lose the ability to walk independently during the course of the disease, which is called "mild GBS"
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Contrary to its name, mild GBS may have an unfavorable clinical course and poor prognosis after supportive treatment alone

Plasma exchange (PE) and intravenous immune globulin (of IVIg) can not be equally effective to walk independently (serious GBS) of GBS patients
.

A trial showed that patients who were still able to walk after two PEs had a shorter start time for exercise recovery, but a randomized controlled trial has not been conducted to evaluate the efficacy of IVIg for mild GBS

Immune Thrombosis

Previous patient studies recruited in the International GBS Outcome Study (IGOS) showed that 75% of patients with mild GBS received IVIg treatment on admission
.

This article uses this difference in current treatment practice to compare the clinical process and results of supportive care or supportive treatment for patients with mild GBS

This article uses this difference in current treatment practice to compare the clinical process and results of supportive care or supportive treatment for patients with mild GBS

diagnosis

Test flow chart

First, the patients with mild GBS at admission were analyzed
.

However, this analysis may include patients who appear early but are destined to develop severe GBS

GBS disability score at different time points

The primary endpoint is functional outcome, which has a lower GBS disability score compared to patients who did not receive IVIg treatment
.

The secondary endpoints were: GBS disability score at 26 weeks, total MRC score, overall constructed disability score (R-ODS) constructed by Rasch, fatigue severity scale, and EuroQol visual analog scale at 4 and 26 weeks, recovery The time to complete muscle strength (MRC total score 60 points), the time to complete disability recovery (GBS disability score 0 points), and hospital admission frequency, progress to GBS disability score 3 or higher, progress to mechanical ventilation, in the fourth Pain and cranial nerve defect occurred at week and 26th week

193 patients with mild GBS were treated as follows: 40 patients (22%) were treated with supportive treatment alone, 148 patients (77%) were treated with IVIg, and 5 patients (3%) were treated with PE
.

Patients who received only PE treatment were excluded from this study

Among untreated patients, 14/31 (45%) had improved in the first week after the start of the study, while among patients treated with intravenous immunoglobulin, only 23/132 (17%) had started There was improvement in intravenous immunoglobulin therapy (p=0.
001)
.

Although this observational study did not find a significant benefit of adding IVIg to the initial supportive treatment of patients with mild GBS, occasional factors may mask the possible positive effects of this treatment

Although this observational study did not find a significant benefit of adding IVIg to the initial supportive treatment of patients with mild GBS, occasional factors may mask the possible positive effects of this treatment.

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