A comparison between plasmapheresis and intravenous immunoglobulin in children with Guillain–Barré syndrome in Upper Egypt

Abstract

Objective: The aim of our study is to assess the clinico-electrophysiological profile of children with Guillain-Barré syndrome (GBS) in Upper Egypt and to compare the efficacy of plasmapheresis versus other treatment modalities. Patients and methods:This was a retrospective study of children from January 2010 to October 2014 diagnosed as GBS. It included 62 cases. Results: Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the most prevalent type of GBS in our locality. As regards the treatment, 32 cases received plasmapheresis while 30 patients received intravenous immunoglobulin. We found a significant decrease in the duration of hospitalization and a significant increase in the number of children with complete recovery in cases treated with plasmapheresis. Conclusion: GBS is not uncommon in children of Upper Egypt, with AIDP the most prevalent type. Plasmapheresis is the best treatment modalities for GBS as it reduces the duration of hospital stay and hastens the recovery of those children.

Nationwide study of therapeutic plasma exchange vs intravenous immunoglobulin in Guillain‐Barré syndrome

“…A case series by Vikrant et al involving 120 TPE sessions performed among 31 GBS patients reported 1 death, for a mortality risk of 3.2% . Saad et al retrospectively evaluated 62 children with GBS from Upper Egypt, comparing treatment outcomes of 32 patients who underwent TPE with those of 30 patients who received IVIG . Unlike our study, theirs suggested no difference in mortality risks between the two treatment modalities, although those who received IVIG had prolonged hospitalization, were less likely to recover, and more likely to require mechanical ventilation than those who underwent TPE …”

“…Previous studies primarily described outcomes of one of these two treatments using case series of patients diagnosed with GBS and/or similar conditions from a single institution. These studies often originated from developing countries . For instance, a retrospective study involving 230 South Indian TPE‐treated patients diagnosed with neurological disorders reported that GBS was a key diagnosis .…”

“…Recently published comparative and noncomparative studies of GBS outcomes after treatment with TPE and/or IVIG have consisted primarily of case reports or case series from single institutions in developing countries, at which the choice between TPE and IVIG is largely dependent on economic considerations . Given the established equivalence between TPE and IVIG as effective treatments for GBS, it is important to evaluate patient‐ and hospital‐level characteristics that may affect treatment selection.…”

Retrospective Analysis of Cases with Guillain-Barré Syndrome in Pediatric Intensive Care Unit

“…21,25 İmmünomodulatuvar tedaviler dışında destek tedavilerinin halen önemini koruduğu da unutulmamalıdır. Çocuk yaş grubunda PD deneyimli merkezlerde düşük komplikasyon oranlarıyla uygulanabilir ancak girişimsel işlemler gerektirmesi (santral kateter) ve özellikle küçük çocuklarda kan prime işlemine (setin işlem öncesi eritrosit süspansiyonu ile doldurulması) gereksinim duyulabilmesi dezavantajları arasındadır.…”

Intravenous immunoglobulin for severe protracted pediatric Guillain–Barre syndrome: Is single dose adequate?

“…[2] According to a study by Saad et al ., plasmapheresis (over IVIg) led to a significant reduction in the duration of hospitalization and faster recovery. [3] Further research is needed in milder disease and delayed treatment (>2 weeks after onset). IVIg is preferred than plasma exchange in children, due to ease of administration and avoidance of invasive catheters.…”