2002, Number 6
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ABSTRACTObjective: To evaluate the efficacy of early therapeutic plasmapheresis in severely affected patients with Guillain-Barré syndrome (GBS). Patients and Method: Patients between 16 to 70 years of age, with GBS according to NINCDS criteria, in stage ≥ 3 of Huges severity score and with less than 7 days of onset of symptoms were admitted for therapeutic plasmapheresis. All patients completed a total of five sessions of plasma exchange every other day using 25% albumin and saline in a 1:1 proportion. Follow-up was performed for 6 months. Friedman and Wilcoxon tests were done to establish differences within groups. Results: A total of 34 patients were admitted to the study. The time span between onset of symptoms and admission to the study was 4 days (median). Fourteen (41%) required mechanical ventilation. Clinical progression of the syndrome was observed during the first two sessions of plasmapheresis. Improvement in motor function by Huges score was observed only after fourth session of plasma exchange (p <0.05). Two patients did not improve, and one died. Conclusions: Clinical improvement in GBS during early therapeutic plasmapheresis occurs only after the fourth session of plasma exchange.
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