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[Immunoadsorption therapy with TR-350 (tryptophan column) for Guillain-Barré syndrome: investigation including serum
T Araki1, H Nakata, S Kusunoki
1Department of Neurology, Kawaguchi Municipal Medical Center.
Immunoadsorption therapy (IAT) using TR-350 was performed for 14 patients with Guillain-Barré syndrome (GBS). Presence of serum antiganglioside antibodies (AGA) was investigated in all the patients in the acute phase. In 14 patients studied, 6 men and 8 women, ages from 24 to 74 years(mean, 42.5 years), 7 patients had suffered from common cold and 3 from diarrhea before neurological onset. Ophthalmoplegia was seen in 6 patients, facial palsy in 6, bulbar palsy in 3 and cerebellar sign in 2. Functional grade scores (FGS) by Hughes et al. of the patients were from 5 to 1 (mean, 3.3). In 4 patients, whose FGS were 1 or 2, IAT were performed, because of worsting of bulbar palsy, bilateral facial palsy and limb weakness. Relapse occurred in one patient. IAT was started from 2 to 18 days (mean, 8.4) after neurological onset and performed 3 to 14 times (mean, 7.5) for each patient. Mean FGS improved from 3.3 to 2.1 after IAT. The mean time to improve 1 grade was 10.3 days and mean time to improve 2 grades was 39.0 days. The mean FGS after 1 month was 1.4 and that after 3 months was 0.4. Some of 14 patients had elevated titers of AGA in sera in the acute phase. Four patients had anti-GQ1b IgG antibody and showed external ophthalmoplegia. One patient with anti-GD1b IgG antibody had cerebellar signs as well as peripheral neuropathy. Those AGAs decreased after IAT in parallel with improvement. IAT is an effective treatment in acute phase of GBS.
Immunoadsorption therapy (IAT) using TR-350 was performed for 14 patients with Guillain-Barré syndrome (GBS). Presence of serum antiganglioside antibodies (AGA) was investigated in all the patients in the acute phase. In 14 patients studied, 6 men and 8 women, ages from 24 to 74 years(mean, 42.5 years), 7 patients had suffered from common cold and 3 from diarrhea before neurological onset. Ophthalmoplegia was seen in 6 patients, facial palsy in 6, bulbar palsy in 3 and cerebellar sign in 2. Functional grade scores (FGS) by Hughes et al. of the patients were from 5 to 1 (mean, 3.3). In 4 patients, whose FGS were 1 or 2, IAT were performed, because of worsting of bulbar palsy, bilateral facial palsy and limb weakness. Relapse occurred in one patient. IAT was started from 2 to 18 days (mean, 8.4) after neurological onset and performed 3 to 14 times (mean, 7.5) for each patient. Mean FGS improved from 3.3 to 2.1 after IAT. The mean time to improve 1 grade was 10.3 days and mean time to improve 2 grades was 39.0 days. The mean FGS after 1 month was 1.4 and that after 3 months was 0.4. Some of 14 patients had elevated titers of AGA in sera in the acute phase. Four patients had anti-GQ1b IgG antibody and showed external ophthalmoplegia. One patient with anti-GD1b IgG antibody had cerebellar signs as well as peripheral neuropathy. Those AGAs decreased after IAT in parallel with improvement. IAT is an effective treatment in acute phase of GBS.
