Immunoglobulins Guillain-Barre syndrome

Hughes RA, Raphael JC, Swan AV, Van Doom PA (2001) Intravenous immunoglobulin for Guillain-Barre syndrome. Cochrane Database Syst Rev CD002063. 

Preparations for intravenous administration are mainly used in patients with general immune deficiency states (primary or secondary) or diseases like idiopathic thrombo-cjhopenic purpura (ITP) and autoimmune diseases (5,6). Neurological disorders (for example Guillain-Barre syndrome and chronic demyelinating polyneuropathy) have been treated with intravenous immunoglobulin (7-9). 

A 70-year-old woman with polycythemia rubra vera and Guillain-Barre syndrome, but no known risk factors for thrombosis, had a cerebral infarction 10 days after receiving intravenous immunoglobulin the authors wondered whether there was a relation to the polycythemia vera (48). 

Bril V, Use WK, Pearce R, Dhanani A, Sutton D, Kong K. Pilot trial of immunoglobulin versus plasma exchange in patients with Guillain-Barre syndrome. Neurology 1996 46(l) 100-3. 

An isolated report describes an epileptic patient taking phenytoin who died, probably from hypersensitivity myocarditis, two days after receiving immunoglobulins for Guillain-Barre syndrome. 

A 14-year-old Japanese girl with Guillain— Barre syndrome was given intravenous immunoglobulin 0.4 g/kg/day and after 3 days developed severe headaches without disturbed consciousness [62 ]. An MRI scan of the brain showed characteristics consistent with posterior reversible encephalopathy syndrome. After the end of the course of intravenous immunoglobulin she recovered. 

A 26-year-old Korean man with Guillain-Barre syndrome was given intravenous immunoglobulin 0.4 g/kg/day for 3 and 6 days later developed multiple reddish severely pruritic vesicles on both palms, diagnosed as pompholyx [66 ]. The vesicles resolved after treatment with topical diflucortolone valerate ointment. 

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