PMID- 9775118
OWN - NLM
STAT- MEDLINE
DCOM- 19981106
LR  - 20190826
IS  - 0248-8663 (Print)
IS  - 0248-8663 (Linking)
VI  - 19
IP  - 1
DP  - 1998 Jan
TI  - [Treatment of Guillain-Barre syndrome in adults: role of plasma exchange].
PG  - 60-8
AB  - PURPOSE: To review recent data on treatment of Guillain-Barre syndrome, 
      especially indications of plasma exchange. DATA SYNTHESIS: Guillain-Barre 
      syndrome is the most common cause of acute flaccid paralysis. The current 
      mortality is 5%, sever motor sequelae persist after 1 year in 10% of cases. 
      Multidisciplinary teams are required to treat these patients, trained to all 
      specific treatments. Oral and intravenous steroids have proven ineffective. Two 
      large randomized clinical trials comparing plasma exchange (PE) with no treatment 
      have shown a short-term and a 1-year benefit. Appropriate number of exchanges and 
      indications are now more precisely known. In mild form (walking possible), 
      patients should receive two PEs. A further two exchanges should be done in case 
      of deterioration or in advanced forms (loss of walking ability, mechanical 
      ventilation). More exchanges are not beneficial. Recently two new randomized 
      trials have produced evidence that intravenous immune globulin (IVIg) (0.4 g/kg/d 
      for 5 days) were as effective as five PEs in advanced forms. The combination of 
      PE with IVIg did not confer a significant advantage, while increasing cost and 
      risks. CONCLUSION: The combination of PE with IVIg did not confer, in advanced 
      forms, the choice between PE and IVIg depends of the contra-indications of each 
      treatment.
FAU - Raphael, J C
AU  - Raphael JC
AD  - Service de reanimation medicale, hopital Raymond-Poincare, Garches.
FAU - Chevret, S
AU  - Chevret S
FAU - Auriant, I
AU  - Auriant I
FAU - Sharshar, T
AU  - Sharshar T
FAU - Bouget, J
AU  - Bouget J
FAU - Bolgert, F
AU  - Bolgert F
LA  - fre
PT  - Comparative Study
PT  - Journal Article
PT  - Review
TT  - Les traitements du syndrome de Guillain-Barre de l'adulte: place des echanges 
      plasmatiques.
PL  - France
TA  - Rev Med Interne
JT  - La Revue de medecine interne
JID - 8101383
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adrenal Cortex Hormones/administration & dosage/therapeutic use
MH  - Adult
MH  - Combined Modality Therapy
MH  - Contraindications
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage/therapeutic use
MH  - Multicenter Studies as Topic
MH  - *Plasma Exchange
MH  - Polyradiculoneuropathy/*therapy
MH  - Randomized Controlled Trials as Topic
MH  - Time Factors
RF  - 39
EDAT- 1998/10/17 00:00
MHDA- 1998/10/17 00:01
CRDT- 1998/10/17 00:00
PHST- 1998/10/17 00:00 [pubmed]
PHST- 1998/10/17 00:01 [medline]
PHST- 1998/10/17 00:00 [entrez]
AID - S0248866397837022 [pii]
AID - 10.1016/s0248-8663(97)83702-2 [doi]
PST - ppublish
SO  - Rev Med Interne. 1998 Jan;19(1):60-8. doi: 10.1016/s0248-8663(97)83702-2.