[Guillain-Barré syndrome treated with high doses of immunoglobulins by the intravenous route: 4 cases].

Plasma exchange is the treatment of choice in Guillain-Barré syndrome, but it has some restrictions. Complications may result from the apharesis procedure (hypovolemia, electrolyte abnormalities), from the replacement fluid, or from preexisting diseases (cardiac arrhythmias). Four patients with Guillain-Barré syndrome were treated with high-dose intravenous immunoglobulins (IgIV): 0.4 g/Kg/day for 5 consecutive days. Three patients had a beneficial response, but 1 did not improve and needed plasma exchange. The mechanisms of IgIV are still imperfectly defined in Guillain-Barré syndrome. IgIV should be reserved for therapeutic failures with plasma exchange, or for patients with contraindications for plasma exchange.