Abd-Allah S A, Jansen P W, Ashwal S, Perkin R M
Department of Pediatrics, Loma Linda University Children's Hospital, CA 92350, USA.
J Child Neurol. 1997 Sep;12(6):376-80. doi: 10.1177/088307389701200607.
Seven children with Guillain-Barré syndrome were treated with intravenous immunoglobulin. Median patient age was 5.8 years. A standard dosage of 0.4 g/kg/day for 5 days was administered. Clinical improvement occurred on average within 2.4 +/- 1.3 days of beginning intravenous immunoglobulin. One child required mechanical ventilation for 7 days. Eight comparable children with Guillain-Barré syndrome at our institution in a prior study treated with plasmapheresis alone had similar clinical results. However, the need for admission to the pediatric intensive care unit and duration of pediatric intensive care unit stay were lower in the intravenous immunoglobulin treated group (P < .05). There were no complications with intravenous immunoglobulin therapy except for a brief episode of hypotension in one patient. Review of the literature identified 74 additional children with Guillain-Barré syndrome successfully receiving intravenous immunoglobulin therapy. We suggest intravenous immunoglobulin as initial therapy for pediatric Guillain-Barré syndrome, because it appears equally as effective as plasmapheresis and is associated with fewer complications.
7名吉兰-巴雷综合征患儿接受了静脉注射免疫球蛋白治疗。患者中位年龄为5.8岁。给予0.4 g/kg/天的标准剂量，持续5天。开始静脉注射免疫球蛋白后，平均在2.4±1.3天出现临床改善。1名儿童需要机械通气7天。在我们机构之前的一项研究中，8名仅接受血浆置换治疗的吉兰-巴雷综合征患儿有类似的临床结果。然而，静脉注射免疫球蛋白治疗组入住儿科重症监护病房的需求和在儿科重症监护病房的住院时间较低（P<0.05）。除1例患者出现短暂低血压外，静脉注射免疫球蛋白治疗无并发症。文献回顾发现另外74名吉兰-巴雷综合征患儿成功接受了静脉注射免疫球蛋白治疗。我们建议将静脉注射免疫球蛋白作为小儿吉兰-巴雷综合征的初始治疗方法，因为它似乎与血浆置换同样有效，且并发症较少。
