Abstract :
Acute inflammatory demyelinating peripheral neuropathy (GuillainBarre-Syndrome) is by far the most common cause of immune-medicated
peripheral nervous system disease in children; with the near disappearance
of poliomyelitis, GBS is responsible for the great majority of cases of
acute flaccid paralysis. So far, in several controlled studies, corticosteroids,
plasmapheresis and IVIG have been utilized in pediatric patients, afflicted
with GBS. Regarding IVIG therapy, two methods have been used; the
high dose (1 gr/kg/day for 2 days), and the low dose (400mg/kg/day for
5 days). Review of literature shows that a faster rate of recovery can be
accomplished in patients who receive total dose of IVIG in 2 days as
compared to the dose being given over 5 days.
Materials & Methods:
In this study we have compared these two types of treatment in an
investigation, conducted in the Mofid Children Hospital on pediatric
patients who had sudden onset of acute flaccid paralysis, and were
diagnosed as having GBS. Based on histories, physical examination and
electrodiagnosis, subjects were divided in two groups, the high dose
IVIG treatment, 1gr/kg/day for 2 days (experimental group), and the low
dose IVIG treatment, 400 mg/kg/day for 5 days (control group). Statistical
analyses were then carried out using the appropriate software.
Results:
Result of this study showed a faster rate of recovery for patients in the
high dose IVIG group; in this group duration of weakness of limbs was
shorter and returning of DTR was faster than in controls. In fact, in this
type of treatment, the relationship between high dose IVIG therapy and
drug side effects was not significant.
Conclusion:
Base upon the finding in the present study, we conclude that the high
dose IVIG therapy is superior to low dose, in view of faster duration of
recovery and shorter hospital stay.
Also we may infer that shorter hospital stay could be a factor in reducing
of more nasocomial infection.
In conclusion, we suggest using high dose IVIG treatment of choice in
GBS.
