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Treatment of Guillain-Barré syndrome by plasma exchange

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Summary

Plasma exchange has been used for therapy in eight patients with the Guillain-Barré syndrome. All patients were severely ill. They became tetraplegic and showed cranial nerve involvement. Five patients received assisted respiration, but the others were also at risk of ventilatory insufficiency. Recovery was abrupt in all cases after the first plasma exchanges. Improvement was more marked when plasmapheresis was done on three successive days with plasma exchanges of 2.0–3.01 each in the initial progressive stage of the disease. A considerable advantage of this therapy is the avoidance of continued artificial respiration and nutrition, which both carry the risk of further complications.

Zusammenfassung

Die Wirksamkeit einer Plasmaaustausch-Behandlung wurde bei 8 Patienten mit einem Guillain-Barré-Syndrom geprüft. Alle Patienten hatten einen schweren Krankheitsverlauf gezeigt, mit schlaffen Tetraparesen und multiplem Hirnnervenbefall. Fünf Patienten mußten assistiert beatmet werden. Auch bei den anderen Patienten zeigten sich Hinweise für eine drohende respiratorische Insuffizienz. Nach den ersten Plasmapheresebehandlungen konnte eine abrupt einsetzende und deutliche Besserung der Ausfälle beobachtet werden. Die klinische Besserung verlief besonders eindrücklich, wenn der Plasmaaustausch an drei aufeinanderfolgenden Tagen mit einer Austauschmenge von jeweils 2,0–3,01 und in der initialen progressiven Phase der Erkrankung erfolgte. Ein großer Vorteil dieser Therapie dürfte in der Vermeidung langzeitiger künstlicher Beatmung und Ernährung und den damit verbundenen Komplikationen liegen.

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Author information

Authors and Affiliations

  1. Department of Neurology and Blood Transfusion Center, University of Innsbruck, Austria

    E. Rumpl, U. Mayr, F. Gerstenbrand & F. Aichner

  2. Department of Anaesthesiology and Blood Transfusion Center, University of Innsbruck, Austria

    J. M. Hackl

  3. Department of Immunology and Blood Transfusion Center, University of Innsbruck, Austria

    P. Rosmanith

Authors
  1. E. Rumpl
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  2. U. Mayr
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  3. F. Gerstenbrand
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  4. J. M. Hackl
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  5. P. Rosmanith
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  6. F. Aichner
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Additional information

Parts of the paper were presented at the International Symposion on Plasma Exchange Therapy, Wiesbaden, April 15/16, 1980 [23]

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Rumpl, E., Mayr, U., Gerstenbrand, F. et al. Treatment of Guillain-Barré syndrome by plasma exchange. J Neurol 225, 207–217 (1981). https://doi.org/10.1007/BF00313750

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  • DOI: https://doi.org/10.1007/BF00313750

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