Plasmapheresis vs Intravenous Immunoglobulin Treatment in Childhood Guillain-Barré Syndrome

Plasmapheresis (PE) is effective in the treatment of Guillain-Barré syndrome (GBS), but it may be technically difficult to perform in children. We have shown that high-dose intravenous (IV) immunoglobulin is also effective in the treatment of childhood GBS.¹ To compare the therapeutic efficacy of IV immunoglobulin and PE, we retrospectively reviewed the charts of 15 consecutive children with a severe form of GBS (functional disability score of grade 4 or worse) who were treated with one of these methods.

Patient Reports. Seven girls and eight boys were treated during the past 5 years. Their mean age was 10.7 years (range, 4 to 16 years). All the children met the National Institute of Neurological and Communicative Disorders and Stroke criteria for the diagnosis of GBS.² All patients, except one with normal laboratory results, had characteristic cerebrospinal fluid abnormalities. Furthermore, all patients had at least one abnormality on nerve conduction