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[Plasmapheresis in Guillain-Barre syndrome]
Angélica Carbajal-Ramírez1, Jorge Alberto Castañón-González, Juan Osvaldo-Talavera
1Servicio de Neurología, Dr. Bernardo Sepúlveda G. del Centro Médico Nacional Siglo XXI, IMSS, México, D.F.
Objective:
To evaluate the efficacy of early therapeutic plasmapheresis in severely affected patients with Guillain-Barré syndrome (GBS).
Patients And Method:
Patients between 16 to 70 years of age, with GBS according to NINCDS criteria, in stage > or = 3 of Huges severity score and with less than 7 days of onset of symptoms were admitted for therapeutic plasmapheresis. All patients completed a total of five sessions of plasma exchange every other day using 25% albumin and saline in a 1:1 proportion. Follow-up was performed for 6 months. Friedman and Wilcoxon tests were done to establish differences within groups.
Results:
A total of 34 patients were admitted to the study. The time span between onset of symptoms and admission to the study was 4 days (median). Fourteen (41%) required mechanical ventilation. Clinical progression of the syndrome was observed during the first two sessions of plasma-pheresis. Improvement in motor function by Huges score was observed only after fourth session of plasma exchange (p < 0.05). Two patients did not improve, and one died.
Conclusions:
Clinical improvement in GBS during early therapeutic plasmapheresis occurs only after the fourth session of plasma exchange.