RELAPSE IN GUILLAIN-BARRE-SYNDROME AFTER TREATMENT WITH HUMAN IMMUNE GLOBULIN

Seven adult patients received human immune globulin intravenously as i nitial therapy for Guillain-Barre syndrome. Although all patients init ially stabilized or improved, five patients deteriorated 1 to 16 days after completion of treatment. In all five patients, clinical worsenin g included loss of at least one functional grade together with a decre ased forced vital capacity. We subsequently treated each patient with a course of plasma exchange, which led to varying degrees of clinical improvement in four. In contrast to previously reported relapse rates for Guillain-Barre syndrome, our experience suggests that clinically s ignificant relapses may occur in patients more often following human i mmune globulin therapy than after either plasma exchange or no therapy .