Intravenous immunoglobulin and Guillain-Barré syndrome

Michal Harel1, Yehuda Shoenfeld

  • 1Department of Internal Medicine B and Research Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.

Guillain-Barré syndrome (GBS) is a relatively common, potentially lethal disease of a presumed autoimmune origin, known to cause a progressive flaccid paralysis. The treatment of GBS consists of both supportive and immunomodulatory treatments, among which intravenous immunoglobulin (IVIg) and plasma exchange (PE) are considered most effective. A number of randomized, controlled studies have shown IVIg to be at least as effective as PE in the treatment of GBS, and in some cases superior. Moreover, IVIg has been found to be safer than PE, having a lower frequency of multiple complications. IVIg has also been found to be both effective and safe in the treatment of pediatric patients with GBS. Thus, its efficacy, safety, and availability make IVIg the treatment of choice in many patients with GBS.

Related Concept Videos

Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which leads...
Myasthenia Gravis: Diagnostic Tests01:15

Myasthenia Gravis: Diagnostic Tests

Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
Myasthenia Gravis ll: Pathophysiology01:22

Myasthenia Gravis ll: Pathophysiology

The disease process of myasthenia gravis begins at the neuromuscular junction, where antibodies attack key proteins needed for muscle activation. This immune reaction weakens signal transmission, leading to the characteristic muscle fatigue and weakness that define the condition.Immune-Mediated DamageIn most individuals, antibodies target acetylcholine receptors (AChRs) on the postsynaptic membrane of muscle cells. By blocking acetylcholine binding, these antibodies prevent the nerve signal...
Poliomyelitis01:17

Poliomyelitis

Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...