scholarly journals Clinical Outcome of Intravenous Immunoglobulin in the treatment of Guillain Barre Syndrome in a Nepalese Tertiary Centre

2019 ◽  
Vol 2 (1) ◽  
pp. 133-137
Author(s):  
Rajeev Ojha ◽  
Ragesh Karn
Keyword(s):  
Intravenous Immunoglobulin ◽  
Axonal Neuropathy ◽  
Immunoglobulin Therapy ◽  
University Teaching ◽  
Guillain Barre Syndrome ◽  
Disability Score ◽  
Acute Motor Axonal Neuropathy ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Intravenous Immunoglobulin is an approved therapy for Guillain Barre Syndrome. Our objective is to understand the management and outcome in Guillain Barre Syndrome patients treated with Immunoglobulin.Materials and Methods: All consecutive patients were retrospectively evaluated in the study were of age ≥16 years and were being admitted in the department of Neurology of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 2016 March to 2017 February.Results: A total of 46 patients were included, mean age= 36.5±16.2 years, range = 16years to 80 years. Thirty-two patients (70%) were axonal variant, acute motor axonal neuropathy is more common (18 patients). Intravenous immunoglobulin was used in 23 patients (50%), 17 of them were axonal variant and 6 were demyelinating. Guillain Barre Syndrome patients with bilateral facial weakness (70% vs 30%; p<0.05) were likely to receive immunoglobulin therapy. Patients with immunoglobulin were found to have higher ODSS at Nadir (9.3±1.8 vs 6.9±1.9; p <0.001) and discharge than patients without immunoglobulin treatment (6.2±1.7 vs 5.0±1.6; p=0.001). At Nadir, Patients with immunoglobulin were found to have higher Guillain Barre Syndrome disability score (4.1±0.7 vs 3.2±0.9; p<0.095). In immunoglobulin group, Axonal variants were found to havehigher ODSS score (9.6±1.9 vs 8.2±0.9, p=0.027) and Guillain Barre Syndrome disability score (4.2±0.7 vs 3.5±0.5; p=0.019) at nadir than demyelinating group.Conclusions: Intravenous Immunoglobulin is easier to administer and is safe with fewer adverse effects. Although expensive, it is an effective treatment option in a resource-limited center. Axonal variants are clinically severe and likely to be need of Intravenous Immunoglobulin therapy.

Does intravenous immunoglobulin therapy in Guillain-Barré syndrome patients interfere with serological Zika detection?

2019 ◽  
Vol 18 (6) ◽  
pp. 632-633
Author(s):  
Anupama Karnam ◽  
Emmanuel Stephen-Victor ◽  
Mrinmoy Das ◽  
Laurent Magy ◽  
Jean-Michel Vallat ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Immunoglobulin Therapy ◽  
Guillain Barre Syndrome ◽  
Intravenous Immunoglobulin Therapy ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

scholarly journals A Case of Guillain-Barré Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrosis Overlap After Pembrolizumab Treatment

2021 ◽  
Vol 9 ◽  
pp. 232470962110374
Author(s):  
Tomoyo Oguri ◽  
Shinji Sasada ◽  
Satoko Shimizu ◽  
Risa Shigematsu ◽  
Yumi Tsuchiya ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Immunoglobulin Therapy ◽  
The Body ◽  
Guillain Barre Syndrome ◽  
Stevens Johnson Syndrome ◽  
Intravenous Immunoglobulin Therapy ◽  
Johnson Syndrome ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
Epidermal Necrosis

A 76-year-old man was admitted to our hospital with Guillain-Barré syndrome (GBS), presenting with facial palsy, dysarthria, and dysphagia as Grade 3 immune-related adverse events (irAEs) due to pembrolizumab administration for Stage IV lung adenocarcinoma. Although prednisolone (1 mg/kg) was started for GBS due to the irAE, dark erythema and skin eruptions appeared on the patient’s torso. Then erosion was observed on 18% of the body surface area and skin biopsy was performed. Finally, the patient was diagnosed with Stevens-Johnson syndrome/toxic epidermal necrosis overlap. Intravenous immunoglobulin therapy was started, and the skin symptoms improved, with the erosion becoming epithelial. He died of aspiration pneumonia related to GBS, although his neurological symptoms had improved after steroid and intravenous immunoglobulin therapy. This is the first reported case of pembrolizumab-induced GBS and Stevens–Johnson syndrome/toxic epidermal necrosis overlap. It is necessary to be careful that the possibility of other severe irAEs may occur simultaneously.

scholarly journals Guillain–Barre Syndrome following Tuberculosis: A Rare Association

2017 ◽  
Vol 08 (02) ◽  
pp. 296-299 ◽  
Author(s):  
Akshay Navalkishor Lakhotia ◽  
Dinesh Chouksey ◽  
Rahul Jain ◽  
Ajoy Kumar Sodani
Keyword(s):  
Case Report ◽  
Pulmonary Tuberculosis ◽  
Intravenous Immunoglobulin ◽  
Axonal Neuropathy ◽  
Guillain Barre Syndrome ◽  
Early Recovery ◽  
Acute Motor Axonal Neuropathy ◽  
Rare Association ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

ABSTRACTThe co-occurrence of Guillain–Barre syndrome (GBS) and tuberculosis is rare. Even in countries like India, where tuberculosis is common, there is only one case report of co-occurrence of GBS with tuberculosis. We report a case of GBS in association with sputum-positive pulmonary tuberculosis. The earliest treatment with intravenous immunoglobulin in acute motor axonal neuropathy variant of GBS would show good early recovery despite associated pulmonary tuberculosis.

scholarly journals Clinical Variants and Evaluation of Clinical Severity of Guillain Barre Syndrome in a Tertiary Care Hospital of Nepal

2019 ◽  
Author(s):  
Rajeev Ojha ◽  
Krishna Kumar Oli ◽  
Bikram Prasad Gajurel ◽  
Ragesh Karn ◽  
Reema Rajbhandari ◽  
...  
Keyword(s):  
Axonal Neuropathy ◽  
Clinical Severity ◽  
Guillain Barre Syndrome ◽  
Care Hospital ◽  
Disability Score ◽  
Acute Motor Axonal Neuropathy ◽  
Diagnostic Certainty ◽  
Number Of Patients ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Abstract Background Guillain Barre Syndrome(GBS) is an acute, frequently severe, and fulminant polyradiculoneuropathy that is autoimmune in nature. Our aim is to evaluate the grading of disability and outcome among different variants of GBS. Methods All consecutive patients recruited prospectively in the study were of age ≥16 years and were being admitted in department of Neurology of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 2016 March to 2017 February. All demographic, historical and clinical data were collected. Nerve conduction study, cerebrospinal fluid analysis along with clinical features were evaluated to assess the diagnostic certainty of Brighton Criteria. Overall disability sum score (ODSS) and GBS disability score were assessed in all patients. The study protocol was approved by the Institutional Review Boards. Results A total of 46 patients were included: male patients being predominant (70% vs 30%), mean age= 36.5±16.2, range = 16 - 80 years. Thirty-two patients (70%) were an axonal variant, acute motor axonal neuropathy being more common (18 patients), and 14 patients were acute motor and sensory axonal neuropathy. Fourteen patients (30%) were demyelinating type, out of which 11 patients had both motor and sensory features, and only 3 patients were pure motor demyelinating type. Axonal variants were found to have higher ODSS during nadir (p=0.024) and discharge(p=0.004), and also higher GBS disability score during nadir (p=0.012) and discharge (p=0.021). Acute motor axonal neuropathy (AMAN) had higher GBS disability score than acute inflammatory demyelinating polyneuropathy (AIDP) at nadir (p=0.034) and discharge (p=0.039). Conclusions Axonal neuropathy variants are predominant among the Nepalese population and are clinically severe than demyelinating variants. Further, prospective study of longer duration to include larger number of patients will be needed.

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