IMMUNE GLOBULINS ARE EFFECTIVE IN SEVERE PEDIATRIC GUILLAIN-BARRE-SYNDROME

The effect of high-dose intravenous immune globulins was evaluated in an open prospective multicenter study of 26 children with severe Guill ain-Barre syndrome. They presented with mild to moderate flaccid weakn ess of extremities, with cranial nerve involvment (20) and sensory imp airment (22). All children rapidly deteriorated in 2-16 days (mean 6) to become bedridden, and 2 children also developed respiratory failure requiring artificial ventilation (Disability Grading Scale 4-5). Immu ne globulins were then administered at a total dose of 2 gm/kg, on 2 c onsecutive days, without adverse effects requiring discontinuation of therapy, Marked and rapid improvement was noted in 25 children, mho im proved by 1 to 2 Disability Grade Scales less than or equal to 2 weeks after the infusion, Twenty were able to walk independently by 1 meek, and 1 could be weaned off a ventilator, Eighteen children recovered b y 2 weeks, The rest recuperated in a period of four months, including a child who was artificially ventilated for 4 weeks. The uniform rapid improvement and recovery associated with immune globulins contrasts w ith the slow recovery course in severe natural cases, We conclude that immune globulins are effective and safe in severe childhood-onset Gui llain-Barre syndrome and therefore may serve as the initial treatment of choice. (C) 1997 by Elsevier Science Inc.