Uses of Intravenous Immunoglobulin: A 13-Year Evaluation of Guillain–Barré Syndrome in Fez, Morocco

Abstract

Plasma-derived medicines in Morocco have been of great demand, and often on a short supply. Moroccan Intravenous Immunoglobulin (IVIG) formulation is still using sugar as stabilizer, while some other industries are discontinuing sugar and currently using amino acid as stabilizer. This is due to the fact that amino acid is rapidly metabolized/cleared from the blood circulation and has fewer adverse effects. The term Guillain-Barré syndrome (GBS) defi nes a recognizable clinical entity that is characterized by rapidly evolving symmetrical limb weakness, loss of tendon refl exes, absent or mild sensory signs, and variable autonomic dysfunction. Few studies have been conducted to investigate the use of IVIG products for GBS in Morocco. The objective of this study was to evaluate the use of IVIG and its adverse effects in Moroccan hospital. This retrospective study was conducted to evaluate the demographic and clinical features in 74 patients with GBS, and to assess the use of IVIG in these patients at University Hospital Hassan II of Fez -Neurology Department from 2003 to 2015. Forty-seven (64 %) male and 27 (36 %) female cases were studied, among whom nine patients had an infection. Eighty eight 88% of total patients had GBS and 12% had chronic infl ammatory demyelinating polyneuropathy (CIDP). Among the 74 patients, 14 % patients showed spontaneous recovery. Twenty eight % of total patients received corticosteroid therapy, 1% of patients underwent Plasma Exchange (PE), 18% (13 patients) received IVIG. Among the 18% that received IVIG, 1 out of 13 patients developed symptoms of hypersensitivity, including fever and chills. Since the use of IVIG resulted in only 1 out 13 patients developed symptoms of hypersensitivity, we concluded that IVIG therapy had a better outcome. IVIG therapy provides patients with GBS, a safer and effective alternative to standard therapies.