Experience of double filtration plasmapheresis in the treatment of Guillain-Barre syndrome

Therapeutic plasma exchange (TPE) is a standard treatment in Guillain-Barre syndrome. TPE may require exogenous fluid for replacement of plasma and, d epending on the equipment used, varying extracorporeal volumes. Potential a dverse effects include allergic reaction, infection, and hypotension. From September 1993 to December 1997, we treated 16 patients with Guillain-Barre syndrome by a newly developed method of automated double filtration plasma pheresis (DFPP). Patients (ten males and six females, age ranged from 16 to 73) suffering from acute ascending motor weakness and fulfilling the diagn ostic criteria for GBS were chosen for DFPP. Each patient received at least five sessions of apheresis in 7 to 10 days and approximately 2.5 to 3.0 L of plasma was treated in each session. Patients were evaluated by disabilit y grade according to a Hughes scale. The mean grade of disability was 3.62 at treatment and improved to 2.37 four weeks after the start of DFPP. The m edian time to grade 2 (walk without support) was 19 days. There were five p atients (41.6%) in need of respirator support. The median time to weaning o ff the respirator was 9 days. Only two patients (12.5%) could not reach gra de 2 at the end of 6 months. Our results were comparable to previously publ ished results of TPE. We conclude that DFPP may be as effective as TPE in t he treatment of GBS. (C) 1999 Wiley-Liss Inc.