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Long‐term prognosis for Guillain‐Barré syndrome: Evaluation of prognostic factors and clinical experience of automated double filtration plasmapheresis
Author(s) -
Cheng BenChung,
Chang WenNeng,
Chen JinBor,
Chee Esther ChungYin,
Huang ChiRen,
Lu ChengHsien,
Chang ChinJung,
Hung PiLien,
Chuang YaoCheng,
Lee ChienTe,
Lee PingYu,
Wang KuoWei,
Chang HsuehWen
Publication year - 2003
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.10066
Subject(s) - medicine , plasmapheresis , guillain barre syndrome , barthel index , disease , pediatrics , surgery , activities of daily living , physical therapy , antibody , immunology
Sixty patients with Guillain‐Barré syndrome (GBS), aged 16–83 years, have been identified over a period of 7 years. Of 60 patients, 30 received the double filtration plasmapheresis (DFP), 4 received intravenous immunoglobulin, and the other 26 received supportive care only. Therapeutic outcomes at 1 year were determined using a modified Barthel index. At a follow‐up of 1 year or longer, 31 patients (52%) had recovered, 24 (40%) had residua, and 5 (8%) had died. According to the statistical analysis, disability at the nadir and electrophysiological signs significantly influenced the long‐term outcomes. Complications associated with DFP procedures included physiologic change, technique‐related complications, and vascular access‐related complications. None of our patients had fatal complications related to DFP treatment. Contrary to the established belief that the disease has a favorable outcome, several hospital‐treated patients may still die or present residua even several months after the onset of symptoms. Because disability at the nadir influences the outcomes, early diagnosis and choice of appropriate treatment, which might include DFP, to prevent further neurological deficits, are essential to maximize the potential for survival. J. Clin. Apheresis 18:175–180, 2003. © 2003 Wiley‐Liss, Inc.