Imai N, Miyata K, Terayama Y, Ishihara N
Department of Neurology, Shimizu Municipal Hospital, Shizuoka Prefecture, Japan.
Rinsho Shinkeigaku. 1997 Jun;37(6):520-2.
We describe a 69-year-old female with Guillain-Barré syndrome (GBS) whose paresthesia and weakness improved after plasma exchange (PE) and intravenous high-dose immune globulin (i.v.I.G.). She felt a paresthesia in her right arm, and 7 days later she noticed right arm weakness followed by gait disturbance within 2 days. She received a series of 6 PEs, but paresthesia and weakness did not improve. Following the last PE trial of this series, she was treated by i.v.I.G. (0.4 g/kg) for 5 days. After i.v.I.G., paresthesia and weakness improved in a few days. After 2nd series of 6 PEs, she was able to walk. In this clinical course, the treatment of i.v.I.G. after PE seemed to be effective. This case raises the possibility that i.v.I.G. might be the treatment in GBS patients with insufficient effect of PE.
我们描述了一名69岁患有吉兰-巴雷综合征(GBS)的女性,其感觉异常和无力在进行血浆置换(PE)和静脉注射大剂量免疫球蛋白(i.v.I.G.)后有所改善。她感到右臂有感觉异常,7天后她注意到右臂无力,随后在2天内出现步态障碍。她接受了一系列6次血浆置换,但感觉异常和无力并未改善。在该系列的最后一次血浆置换试验后,她接受了5天的静脉注射免疫球蛋白(0.4 g/kg)治疗。静脉注射免疫球蛋白治疗后,感觉异常和无力在数天内得到改善。在进行第二系列的6次血浆置换后,她能够行走了。在这个临床过程中,血浆置换后静脉注射免疫球蛋白的治疗似乎是有效的。这个病例提出了一种可能性,即静脉注射免疫球蛋白可能是对血浆置换效果不佳的GBS患者的治疗方法。