PMID- 30550005
OWN - NLM
STAT- MEDLINE
DCOM- 20190523
LR  - 20190523
IS  - 1565-1088 (Print)
VI  - 20
IP  - 12
DP  - 2018 Dec
TI  - The Efficacy of Intravenous Immunoglobulin in Guillain-Barre Syndrome: The 
      Experience of a Tertiary Medical Center.
PG  - 754-760
AB  - BACKGROUND: Guillain-Barre syndrome (GBS) is an autoimmune disease of the 
      peripheral nervous system with a typical presentation of acute paralysis and 
      hyporeflexia. Intravenous immunoglobulin (IVIG) and plasma exchange (PLEX) are 
      treatments that have proven to expedite recuperation and recovery of motor 
      function. OBJECTIVES: To describe our experience at one tertiary medical center 
      treating GBS with IVIG and to compare the efficacy of IVIG as the sole treatment 
      versus combined therapy of IVIG and plasma exchange. METHODS: We reviewed the 
      records of all patients diagnosed with GBS and treated with IVIG at the Sheba 
      Medical Center from 2007 to 2015 and collected data on patient demographics, 
      disease onset and presentation, and treatments delivered. The motor disability 
      grading scale (MDGS) was used to evaluate the motor function of each patient 
      through the various stages of the disease and following therapy. RESULTS: MDGS 
      improvement from admission until discharge was statistically significant (P < 
      0.001), as was the regainment of motor functions at 3 and 12 months follow-up 
      compared to the status during the nadir of the disease. The effectiveness of 
      second-line treatment with IVIG following PLEX failure and vice versa was not 
      statistically significant (P > 0.15). CONCLUSIONS: The majority of patients 
      included in this study experienced a significant and rapid improvement of GBS 
      following treatment with IVIG. Combined therapy of PLEX and IVIG was not proven 
      to be effective in patients who encountered a failure of the first-line 
      treatment.
FAU - Shalem, Dvir
AU  - Shalem D
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Shemer, Asaf
AU  - Shemer A
AD  - Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 
      Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Shovman, Ora
AU  - Shovman O
AD  - Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 
      Israel.
AD  - Department of Medicine 'B', Sheba Medical Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Shoenfeld, Yehuda
AU  - Shoenfeld Y
AD  - Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 
      Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Kivity, Shaye
AU  - Kivity S
AD  - Borenstein Talpiot Medical Leadership Program, 2013, Sheba Medical Center, Tel 
      Hashomer, Israel.
AD  - Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, 
      Israel.
AD  - Department of Medicine 'A', Sheba Medical Center, Tel Hashomer, Israel.
AD  - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Combined Modality Therapy
MH  - Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Guillain-Barre Syndrome/immunology/physiopathology/*therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage
MH  - Immunologic Factors/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Plasma Exchange/*methods
MH  - Retrospective Studies
MH  - Tertiary Care Centers
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2018/12/15 06:00
MHDA- 2019/05/24 06:00
CRDT- 2018/12/15 06:00
PHST- 2018/12/15 06:00 [entrez]
PHST- 2018/12/15 06:00 [pubmed]
PHST- 2019/05/24 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2018 Dec;20(12):754-760.