Child with Guillain-Barré Syndrome Responding to Plasmapheresis: A Case Report

Abstract

Intravenous immunoglobulin (IVIG) has long been regarded as the first-line treatment for Guillain-Barré syndrome (GBS), with plasmapheresis only being reserved for severe cases or used as an additional therapy of unproven efficacy. Here, we present the case of a 9-year-old girl with acute motor axonal neuropathy (AMAN), a rapidly progressive subtype of GBS that caused her to fall into respiratory failure. The patient failed to show a response 10 days after starting IVIG, but showed rather quick improvement with plasmapheresis. She received a total of 5 sessions of plasmapheresis on alternate days over a course of 8 days. Before starting plasmapheresis, her muscle strength was 2/5 in both upper limbs and 1/5 in both lower limbs, and she was dependent on mechanical ventilation. Following the first session, her power improved from 2/5 to 4/5 in the upper limbs, and the gag and sucking reflexes were recovered. On day 3, after the second session was initiated, she was extubated successfully (having been on a ventilator for 2 weeks) and remained on continuous positive airway pressure for the next 48 h, after which she was on room air. In addition, she was having hypertension from the first day of the diagnosis (which was due to autonomic instability), which improved after clonidine to maintain her blood pressure. She was also initially having urinary retention, then was off Foley's catheter. The patient was discharged from the hospital 2 weeks following the first session of

Efficacy and Safety of Therapeutic Plasma Exchange in Pediatric Patients with Guillain-Barré Syndrome: A Retrospective Study

“…This contrasts with some studies reporting higher percentages (above 75%) in pediatric patients early in the disease course [1,33,35,39]. Other studies suggest that normal CSF results may be observed within one week after symptoms onset [2,3,6,8], which may explain the results in our study. This warrants further investigations for future work to determine the optimal timing for diagnostically informative CSF analysis, at which it would serve as a good diagnostic test for GBS.…”

“…Notably, TPE has demonstrated effectiveness comparable to, or even surpassing, IVIG, while also proving to be more cost effective. This assertion aligns with őndings reported from numerous previous case series and cohort studies [2,10,28,29,33,34]. This retrospective study investigates and delves into the efficacy and safety of TPE in the management of GBS in pediatric patients, with the objective of providing valuable insights for potential inclusion in future larger-scale trials.…”

Therapeutic plasma exchange as a first‑choice therapy for axonal Guillain‑Barré syndrome: A case‑based review of the literature (Review)

“…The main aim of the present article is to report the efficacy of TPE in a severe and rapidly progressive AMAN subtype of GBS. Another recently published case report showed the beneficial effect of TPE after IVIg failed to improve the neurological condition of a child diagnosed with the AMAN subtype of GBS (59). Cases such as this may be included in retrospective studies on the efficacy of different treatments for the axonal forms of GBS.…”

Neurological Manifestations of Covid-19 Hospitalized Patients In the state of Punjab, India

“…22,23 This syndrome often responds to immunoglobulin when administered intravenously. 24 Myalgia/fatigue is often seen, and raised creatine kinase levels point to injury of muscle. 25 Most of the neurological complications are currently reported from the Chinese population.…”